Mysterious Illness Striking Young Workers In The South
Doctors at Harris County's public hospitals have spent more than a decade treating an unusual group of dialysis patients, men in their 20s and 30s who work outdoors and whose kidneys have failed without a clear medical explanation, Fox News reports, following a Texas Monthly investigation.
A review of county hospital records found that roughly one in six emergency dialysis cases among uninsured or undocumented patients had no identifiable cause. The records ran from 2012 to 2015, and the study was published as a preprint last year. One physician told Fox the share is consistent with chronic kidney disease of unknown etiology, a condition that has caused widespread deaths among laborers in hot regions abroad but has rarely been documented in the United States until now.
Many of the patients are immigrants from Mexico and Central America, often illegal aliens, and they work in roofing, construction and other trades that demand hours of strenuous labor in extreme heat. Few have diabetes or high blood pressure, which account for most kidney failure nationwide. For someone that young, the loss of kidney function can mean dialysis several times a week for the rest of his life.
First identified among sugar-cane workers in Central America, the illness has since appeared in parts of South Asia and Mexico, where many young patients died without access to dialysis. A 2019 article in the New England Journal of Medicine called it "a sentinel disease in the era of climate change," though researchers still disagree over whether heat causes the disease or only worsens it.
Gauging how widespread the problem is will be difficult. Kidney function can erode for years without noticeable symptoms, and many patients learn they are sick only when fatigue, nausea or breathlessness signal that their kidneys are nearly gone.
Medicine offers limited help once the damage is done. No single test confirms the disease, so doctors reach the diagnosis by ruling out other causes and examining a patient's work history. Treatment focuses on preserving what function remains and controlling blood pressure until dialysis or a transplant is unavoidable.
Dr. Richard J. Johnson, an emeritus professor of medicine at the University of Colorado and a leading expert on kidney diseases, has cautioned that some patients are treated with ACE inhibitors, medicines commonly prescribed for high blood pressure, even though those drugs can sometimes worsen kidney function in people who are already dehydrated.
"Disease often progresses rapidly over a few years, and dialysis and transplantation are rarely available, so mortality is high," he told Fox News.
Dr. Gokul Paidi, a New York family physician who has published a review of the condition, told the outlet that outdoor laborers in hot climates should have 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 said.
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