Tackling heat-related kidney injury and disease

As temperatures rise and heatwaves multiply, the threat that extreme heat poses to kidney health is becoming harder to ignore. But governments and other stakeholders must act amid gaps in the evidence about who is most at risk and which measures work best. Following its report, “Beating the heat: Protecting kidney health in a warming world”, Economist Enterprise convened policy experts on September 17th 2026 to consider what governments and stakeholders can do now and where better evidence could sharpen their response.  

The discussion identified the following priorities:

Policy interventions

Integrate kidney health into broader plans and policies that address extreme heat. There is no need to reinvent the wheel. Many jurisdictions already have funded arrangements to respond to heatwaves and prolonged periods of high temperatures. Yet kidney health is often not addressed explicitly within these frameworks, or remains an emerging consideration. Integrating it more clearly into existing policies would make plans more effective at reducing heat-related health harms, while linking kidney care to broader measures such as improved housing and access to cooling.

Embed a multisectoral approach for success. Heat affects almost every part of society, so plans must draw in all parts of government, business and other groups that can help. Each plan should reflect local needs and resources, but no single organisation can manage extreme heat alone. Governments should involve all departments that have a role to play. These include finance ministries that can fund action, as well as agencies responsible for public health, emergency services, utilities, transport, housing, labour rules and weather forecasting. Cultural bodies can also help reach people and change behaviour. Private groups, including employers and non-governmental organisations, must also be engaged. Co-ordinating so many participants requires clear communication, defined roles and accountability for results. Metrics should track outcomes such as healthcare costs, heat-related injuries and deaths. Plans also need dedicated funding that can be released quickly when extreme heat strikes. Political change poses another risk. Shifting government priorities and election cycles can disrupt long-term action. Embedding heat-health measures in budgets and government plans can help them endure changes in political leadership cycles.

Research and evidence priorities

Medical science has to move towards a comprehensive and nuanced understanding of heat’s effect on kidney health. Current research strongly indicates that high levels of heat for extended periods can undermine a person’s kidney health. This is enough to justify preventive action but insufficient for understanding the ideal scope of interventions. Safe heat duration and exposure thresholds remain unclear, while longitudinal evidence across different populations and settings is also needed. This is just one important aspect of the lack of a broader framework for understanding the biological interplay between heat and kidney health.

More human stories and data from diverse sources are needed to show the scale of heat’s impact on kidney health. As average temperatures rise and heatwaves become more frequent, such data will be increasingly vital. Yet population-level evidence on the links between heat and kidney disease remains limited, including data that connect environmental exposure with health outcomes. Meanwhile, even in some rich countries, inconsistencies remain in morbidity and mortality tracking practices. In the resulting data, heat-related deaths are also often under-reported or published only after a significant time lag. Not surprisingly, registry data, where it exists, also takes years to become public or may not connect across data silos. Important information for regions or urban areas, such as comprehensive data from city hospitals linking heat and kidney emergencies, is also hard to obtain. Governments should develop integrated surveillance systems that connect meteorological, clinical, occupational and social data, allowing emerging heat-related kidney risks to be detected and interventions evaluated. While data is essential as national and local officials shape policy choices, perhaps more important will be illustrative human stories of how people are affected. These are typically more powerful than other information at motivating action.

Researchers should identify understudied groups at greater risk of heat-related kidney disease. Heat’s impact on kidney injury and chronic kidney disease is well-documented for certain groups, notably male agricultural workers. They are unlikely to be exceptional. Health systems and policymakers need insight into the risks for other groups exposed to high heat. Research should consider groups that fall within any one of the following categories, as well as those whose circumstances span multiple categories: 

• Other outdoor occupational groups—such as saltpan or construction workers—and those who work inside in very hot conditions—such as factory or piece workers. This research should also include vulnerable migrant and seasonal workers, gig workers, informal workers and even tourists.

• People, typically of low socioeconomic status, with inadequate or no housing, and so lacking the ability to protect themselves from heat. Clearer evidence is needed on when prolonged indoor heat in homes becomes harmful, so that housing interventions can be targeted effectively to protect residents.

• Understudied demographic groups, including women and girls, whose exposure, susceptibility or access to protection may differ because of sex- or gender-related factors.

• Those already with impaired kidney reserves, such as older people or those living with diseases such as chronic kidney disease (CKD), diabetes and cardiovascular disease.

Health economists need to give policymakers data on the costs of action and inaction. Amid competing priorities, policymakers will not adopt any proposed action without knowing the cost. They also consider policy benefits, such as the costs they can avoid by reducing the health burden. Many health systems lack data on the specific economic burden of heat on kidney health, such as its share in increasing treatment budgets for kidney injury or CKD, let alone in driving transplant numbers. More broadly, cost-of-disease studies on lost work years are also needed. With costs and benefits spread unevenly within societies or, for migrant or informal workers, across more than one, the research may be complex. It is, nevertheless, necessary.