Mysterious chronic kidney disease with no known cause found in Texas

Key Points:

• Chronic kidney disease of unknown etiology (CKDu), previously seen mainly in Central America and South Asia among agricultural workers, has now been identified in Texas, particularly affecting young to middle-aged men in outdoor labor jobs under extreme heat conditions.
• CKDu develops without traditional risk factors like diabetes or hypertension and is characterized by rapid progression to kidney failure, often without early symptoms, making early detection challenging.
• Heat stress, repeated dehydration, exposure to pesticides, unsafe drinking water, and use of NSAIDs are suspected contributors to CKDu, with prevention strategies focusing on improved hydration, shade, and adjusted work hours.
• Diagnosis is made by excluding other causes of kidney disease and considering occupational exposures, but there is no specific test or treatment; management includes controlling blood pressure and avoiding further kidney damage, with dialysis or transplantation rarely accessible in affected populations.
• Experts recommend regular kidney function screening for individuals in high-risk outdoor labor roles, emphasizing early detection through blood and urine tests to prevent progression to end-stage kidney disease.