{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T21:49:04Z","timestamp":1789681744808,"version":"4.0.1"},"reference-count":43,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"unspecified","delay-in-days":146,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"crossref","award":["P20ES036110"],"award-info":[{"award-number":["P20ES036110"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"crossref","award":["P30ES019776"],"award-info":[{"award-number":["P30ES019776"]}],"id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000062","name":"National Institutes of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","award":["R01DK133650"],"award-info":[{"award-number":["R01DK133650"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,5,12]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Elevated ambient temperatures increase the risk for acute kidney-related morbidity, and medication use may increase vulnerability to heat exposure. This study examines whether medication use, and combination medication use (ie, polypharmacy), modifies the risk for temperature-related volume depletion (VD) and acute kidney injury (AKI).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This study uses patient-level emergency department (ED) visit data from four Atlanta-area hospitals during the warm season from 2013 to 2019. ED patient-visits who reported a medication were matched with up to five ED patient-visits without the medication. Medications included angiotensin converting enzymes and angiotensin receptor blockers (ACE\/ARBs), anti-depressants, anti-convulsants, \u03b2-blockers, diuretics, non-steroidal anti-inflammatory drugs and statins. A case-crossover framework is used to estimate associations between daily maximum temperature, medication use and VD\/AKI ED visits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 14 635 VD and 18\u2009716 AKI ED visits in this study. For a change in ambient temperature (lags 0\u20132) from the 50<jats:sup>th<\/jats:sup> to 95<jats:sup>th<\/jats:sup> percentiles, patients using antidepressants had a higher risk for AKI (OR 1.28, 95% CI 1.08 to 1.52) compared with antidepressant nonusers (1.03, 95% CI 0.95 to 1.12). Polypharmacy analysis indicated that patients taking statins with ACE\/ARBs were at an elevated risk for AKI (OR 1.38, 95% CI 1.02 to 1.86) relative to all other groups. This includes patients taking only an ACE\/ARB (OR 1.00, 95% CI 0.82 to 1.21), only a statin (OR 1.10, 95% CI 0.90 to 1.33) or neither medication (OR 1.07, 95% CI 0.93 to 1.23).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Results show that both single and combined medication use are associated with elevated risk for VD and AKI during periods of elevated ambient temperature.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjph-2024-001703","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T23:20:18Z","timestamp":1748388018000},"page":"e001703","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Case-crossover assessment of the modifying effects of home medication use on acute kidney-related morbidity due to elevated ambient heat exposure in Atlanta, GA, from 2013 to 2019"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0886-2882","authenticated-orcid":false,"given":"Zachary","family":"McCann","sequence":"first","affiliation":[{"name":"Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haisu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Mueller","sequence":"additional","affiliation":[{"name":"Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaoyao","family":"Qian","sequence":"additional","affiliation":[{"name":"Allergy and Lung Health Unit, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Lane","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Dsouza","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E Jennifer","family":"Weil","sequence":"additional","affiliation":[{"name":"Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4713-2337","authenticated-orcid":false,"given":"Stefanie","family":"Ebelt","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah","family":"Scovronick","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard H","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,5,27]]},"reference":[{"key":"2025083110322802000_3.1.e001703.1","doi-asserted-by":"crossref","unstructured":"Schwingshackl C , Sillmann J , Vicedo\u2010Cabrera AM , et al . 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