Environmental Heat and Renal Health Across Cosmopolitan Populations: A Scoping Review Focused on Sex-Specific Vulnerability.

Objectives: Much of the existing evidence on heat-renal associations has focused on Mesoamerican male agricultural workers as the primary high-risk group, leaving sex-specific vulnerability in non-agricultural global populations underexplored. This study synthesized global evidence on heat-related renal outcomes in non-Mesoamerican, non-agricultural populations, with a focus on differences by sex. Methods: A scoping review was conducted following PRISMA-ScR guidelines. Eligible studies reported sex-stratified renal outcomes and were conducted in non-Mesoamerican, non-agricultural populations. Data were extracted in duplicate and summarized descriptively. Results: Twenty-one studies from ten countries met the inclusion criteria. Heat exposure was associated with increased risks of acute kidney injury, nephrolithiasis, and urinary tract infections. Men generally showed greater vulnerability to acute kidney injury and stone-related outcomes, whereas women more often demonstrated heat-related increases in urinary tract infections. Conclusion: Our findings indicate that the risk of heat-related renal morbidity is not confined to the traditionally studied Mesoamerican male agricultural workforce but may also represent an emerging health concern in urban and metropolitan settings. These sex-specific patterns highlight the need for gender-responsive approaches in heat-renal research and public health planning.