A mysterious kidney disease known as a ‘silent killer’ is striking young and otherwise healthy men in Texas.
Chronic kidney disease of unknown etiology (CKDu) is a condition diagnosed when a patient suffers from kidney failure and the kidneys stop filtering the blood correctly – which can be fatal – despite having no other risk factors for kidney disease, such as obesity, high blood pressure or diabetes.
It was first recognized in the 1990s, after it was recorded in Central and South America, where it is called Mesoamerican Nephropathy, and has also been detected in India and South Asia.
It has historically been rarely detected in the US.
But now, doctors at multiple Texas hospitals are reporting cases of the disease.
Physicians in Houston say they have recorded a number of cases, almost all in otherwise healthy men in their 20s and 30s.
The patients were often laborers and had collapsed while at work, they said, whether that was painting a wall or paving a road.
Dr Jason Glaser, a general surgeon in Texas, warned: ‘I’m really worried these people are going to fall through the cracks and die.’
Doctors in Texas are warning that they have detected a mysterious kidney disease called Chronic kidney disease of unknown etiology
CKDu is considered to be a mystery because doctors are not sure what’s causing it, although they know it cannot be spread from person to person.
The leading hypothesis among researchers is that it is caused by exposure to extreme heat for long periods, such as when working outdoors.
Dr Marvin Gonzalez Quiroz, an occupational health expert at the University of Texas, San Antonio, previously told Texas Public Radio: ‘The most likely hypothesis is that repeated episodes of heat stress combined with dehydration in workers doing intense physical labor in a hot environment may lead to a recurrent acute kidney injury.
‘This gradually accumulates and results in chronic kidney disease of unknown etiology.’
Doctors in Houston revealed they were recording cases of the disease to Texas Monthly, saying they had been detecting them for about a decade.
The physicians, who worked at safety-net hospitals, or hospitals that treat people regardless of their health insurance status, said many of the patients were undocumented migrants.
All had come to the US from Central or South America and were working in the US when they sought treatment.
The patients were at Ben Taub hospital and other safety-net hospitals in Harris county, which covers Houston.
The above map shows the locations where CKDu has been reported. Red areas are ‘hotspots’ for the disease and orange areas are places where it has previously been reported
It was not clear how many cases, hospitalizations or deaths due to the disease have been recorded to date or how many resulted in kidney transplants.
Among the first CKDu cases recorded in the US was one from 2018, when a 41-year-old truck driver who had immigrated from El Salvador was diagnosed with the condition. Doctors in Washington DC who reported the case said he was an agricultural field laborer.
Since then, isolated cases have been reported in California, Texas and Florida.
CKDu is most commonly recorded in young or middle-aged adults, typically men, who live in rural areas and work in extreme conditions. Patients diagnosed with the disease are often laborers or agricultural workers.
It is called a ‘silent killer’ because it triggers no warning signs until the later stages, by which time the kidneys, which are essential organs, may be too damaged to save, putting someone’s life at risk.
The organs are vital for the body and function by filtering waste and potentially toxic substances out of the blood. If they stop working properly, these substances accumulate in the blood, eventually leading to death.
Warning signs of kidney damage include nausea, vomiting, loss of appetite, fatigue and weakness and sleep problems. Many CKDu patients report suffering from extreme fatigue.
It is not clear how many people may have the condition globally, as it is mostly reported in less developed countries that do not record these figures.
But chronic kidney disease, where the kidneys have been damaged over time and do not filter the blood as well as they should, is a growing health problem globally.
In 2016, 275.9 million people globally were estimated to be suffering from the condition, compared to 147.6 million in 1990.
In India, CKDu is the second leading cause of chronic kidney disease, behind an estimated 16 percent of cases. Diabetes was the main cause, behind nearly a third of cases.
Doctors can treat the condition using blood pressure medications and can ease symptoms using dialysis, which clears waste products from the blood.
In serious cases, doctors may also carry out a kidney transplant to save a patient.
To prevent the disease, doctors advise people to drink plenty of water while working outdoors.
Dietitians recommend consuming plenty of fluids on a hot day. The National Academy of Medicine says men should drink 3.7 liters of water per day, equivalent to 15 glasses, while women should consume 2.7 liters, or 12 cups.
If urine is a dark yellow color or smells, dietitians say that is an indication that someone needs to drink more water.
