The management of chronic kidney disease (CKD) patients in cold areas is an important task in the daily practice of primary medical and health institutions. An important way to reduce the burden of CKD is to achieve early identification of and implement timely intervention on the relevant risk factors. Studies have shown that diet, alcohol, tobacco, air, sedentary and other factors in cold areas have negative impacts on human kidneys; yet, our current understanding of the effect of cold stimulation on CKD remains blurry. This paper introduces the research progress of risk factors related to CKD in cold areas and analytically summarizes the pathogenesis of CKD caused by cold stimulation, aiming to provide a reference work for the prevention, screening, evaluation, and management of CKD in cold areas.

  Objective  To explore the effects of daily mean temperature (℃), average daily air pressure (hPa), humidity (%), wind speed (m/s), particulate matter (PM) 2.5 (μg/m³) and PM10 (μg/m³) on the admission rate of chronic kidney disease (CKD) patients admitted to the Second Affiliated Hospital of Harbin Medical University in Harbin and to identify the indexes and lag days that impose the most critical influence.  Methods  The R language Distributed Lag Nonlinear Model (DLNM), Excel, and SPSS were used to analyze the disease and meteorological data of Harbin from 01 January 2010 to 31 December 2019 according to the inclusion and exclusion criteria.  Results  Meteorological factors and air pollution influence the number of hospitalizations of CKD to vary degrees in cold regions, and differ in persistence or delay. Non-optimal temperature increases the risk of admission of CKD, high temperature increases the risk of obstructive kidney disease, and low temperature increases the risk of other major types of chronic kidney disease. The greater the temperature difference is, the higher its contribution is to the risk. The non-optimal wind speed and non-optimal atmospheric pressure are associated with increased hospital admissions. PM2.5 concentrations above 40 μg/m³ have a negative impact on the results.  Conclusion  Cold region meteorology and specific environment do have an impact on the number of hospital admissions for chronic kidney disease, and we can apply DLMN to describe the analysis.

  Objective  Effective Chronic Kidney Disease (CKD) management is particularly important in cold regions of China, where climate and lifestyle factors play significant roles. However, there is a lack of relevant studies in this area. Therefore, the purpose of this study was: (1) to assess the status of self-management capacity in individuals with CKD in cold regions of China and analyze the factors influencing it; (2) to identify strategies to improve CKD management in primary care settings in these regions; and (3) to understand patients' attitudes toward eHealth services.  Methods  This was a regional, cross-sectional observational study. A questionnaire measuring CKD patients' self-management abilities was derived from the Perceived Kidney Disease Self-Management Scale, the Kidney Disease Behavioral Inventory (KDBI), and the Health Literacy Questionnaire. Data were collected from hospitalized CKD patients in Heilongjiang Province and analyzed using One-Way Analysis of Variance (ANOVA), Hierarchical Regression Analysis, and K-prototype cluster analysis.  Results  A total of 957 participants were tested. Of these, 70.64% had less than a bachelor's degree, and 56.27% had been diagnosed with hypertensive or diabetic nephropathy. The KDBI scale showed a lower overall score compared to the PKDSMS. Factors such as CKD stage 4 (F = 2.367, P = 0.042), last year's medical expenses (F = 3.974, P = 0.004), and poor self-rated health (F = 33.352, P < 0.01) were found to influence scores on both scales. The health literacy questionnaire revealed significant differences (P < 0.01) in health knowledge, except by sex. Additionally, healthcare expenditures and poor self-rated health were negatively associated with self-management capacity.  Conclusions  This study provides valuable insights into the self-management challenges faced by CKD patients in cold regions of China. Despite some difficulties in improving self-management, patients showed positive attitudes toward enhancing CKD management services in primary care and developing digital management tools. These findings offer useful references and recommendations for future clinical practice and research in this field.