{
  "abstract": "Background: Rising ambient temperatures and increasing thermal stress are major public health challenges, associated with increased emergency department (ED) visits in Europe. Frequently prescribed diuretics may exacerbate heat-related risks through mechanisms such as dehydration and electrolyte imbalance. Although many studies have shown a connection between temperature and mortality, the effect of cumulative ambient temperature on diuretic-associated adverse drug reactions (ADRs) remains underexplored. This study investigates whether higher temperatures are associated with an increase in diuretic-related ADRs in ED admissions.\n\nMethods: Data from a prospective, observational study on ADRs leading to ED admission (ADRED-study) with a standardized causality assessment of documented drugs were analyzed. Linear, polynomial, and segmented regression were applied to quantify the relationship between 5-day mean temperature and the ratio of suspected diuretic-related ADRs to all diuretic uses.\n\nResults: A significant relationship between higher 5-day mean temperatures and more diuretic-associated ADRs was found in linear regression analysis (β = 0·0035, 95%CI: 0·0015 − 0·0054, R²=0·188). A segmented regression model identified a critical threshold of ~ 15·7 °C (adjusted R ² = 0·382). After the threshold at higher temperatures, the slope for diuretic-associated ADRs increased significantly (β = 0·0201, 95%CI: 0·0068–0·0333). The spline model similarly showed a high statistical fit (adjusted R ² = 0·399), indicating a non-linear, accelerating increase in ADRs at higher temperatures.\n\nConclusions: Diuretic-associated ADRs increase non-linearly with ambient temperature, with a breakpoint at approximately 15·7 °C. Especially diuretic-medicated individuals may be vulnerable to cumulative thermal stress.\n\nTrial registration: The ADRED-study was registered in the German Clinical Trials Register under DRKS00008979.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 10,
  "authors": [
    {
      "name": "Jakob Sommer",
      "orcid": "0009-0001-1582-2264"
    },
    {
      "name": "Justyna Wozniak"
    },
    {
      "name": "David Wißmann"
    },
    {
      "name": "Judith Berres"
    },
    {
      "name": "Verena Graeff",
      "orcid": "0000-0001-6188-1874"
    },
    {
      "name": "Andrea Kriegisch-Stumpf"
    },
    {
      "name": "Anja Knüppel-Ruppert"
    },
    {
      "name": "Harald Dormann"
    },
    {
      "name": "Julia C Stingl"
    },
    {
      "name": "Katja S Just",
      "orcid": "0000-0002-6782-8078"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1xwk52ht6yv23.bib",
  "cited_by": 0,
  "doi": "10.1186/s12916-026-05370-1",
  "fulltext_url": null,
  "id": "1xwk52ht6yv23",
  "issns": [
    "1741-7015"
  ],
  "landing_url": "https://link.springer.com/article/10.1186/s12916-026-05370-1",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-07",
  "publisher": "Springer Science and Business Media LLC",
  "ris": "https://research.draconitic.com/paper/1xwk52ht6yv23.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:21:00Z",
      "native_id": "10.1186/s12916-026-05370-1",
      "source": "crossref",
      "url": "https://link.springer.com/article/10.1186/s12916-026-05370-1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "journal-openalex:F27",
      "subfield": "general"
    }
  ],
  "title": "Diuretic-associated admissions to the emergency department – too hot to handle? Results from the ADRED-study",
  "title_text": "Diuretic-associated admissions to the emergency department – too hot to handle? Results from the ADRED-study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-09T00:20:54Z",
  "url": "https://research.draconitic.com/paper/1xwk52ht6yv23",
  "venue": "BMC Medicine",
  "versions": []
}