BY SRH
According to a story from Texas Monthly, doctors at Harris County’s public hospitals have been taking care of a strange group of dialysis patients for more than ten years. These people are men in their 20s and 30s who work outside and whose kidneys have failed for no clear medical reason.
A study of hospital records from the county found that one in six emergency dialysis cases involving uninsured or undocumented patients had no clear cause. The records were kept from 2012 to 2015, and the study came out last year as a preprint. Fox talked to a doctor who said the share fits with chronic kidney disease of unknown cause. This is a condition that has killed a lot of workers in hot places abroad but hasn’t been seen much in the US until now.
A lot of the patients are illegal immigrants from Mexico and Central America. They work in trades like roofing, construction, and other jobs that require long hours of hard work in very hot conditions. Not many people have diabetes or high blood pressure, which are the main causes of kidney failure in the United States. Losing kidney function at that age can mean that person needs dialysis several times a week for the rest of their lives.
The disease was first found in sugar-cane workers in Central America. It has since spread to parts of South Asia and Mexico, where many young patients died because they couldn’t get dialysis. In 2019, the New England Journal of Medicine called it “a sentinel disease in the era of climate change.” However, researchers are still not sure if heat causes the disease or just makes it worse.
It will be hard to figure out how common the problem is. Kidney function can decline for years without any obvious signs. In fact, many people don’t realize they are sick until they are tired, sick, or short of breath, which are all signs that their kidneys are almost gone.
Once the damage is done, medicine can only do so much to help. Since there isn’t a single test that can prove the disease, doctors figure it out by ruling out other causes and looking at the patient’s work history. The main goals of treatment are to keep the remaining functions and blood pressure under control until dialysis or a donation is required.
As an emeritus professor of medicine at the University of Colorado and a leading expert on kidney diseases, Dr. Richard J. Johnson has warned that some patients are being treated with ACE inhibitors, which are drugs that are often prescribed for high blood pressure, even though they can make kidney function worse in people who are already dehydrated. “Disease often gets worse quickly over a few years, and dialysis and transplantation are rarely available, so death rate is high,” he told Fox News.
A family doctor in New York named Dr. Gokul Paidi, who has written a review of the condition, told the news source that people who work outside in hot conditions should have their kidney function checked at least twice a year. “A simple blood test for creatinine (a waste product normally filtered from the blood by the kidneys) and a urine test for protein can catch early changes long before symptoms appear,” he stated.
