Further Understanding CKDu While Mitigating Risks
The acute health effects of heat are well known, ranging from unease, to fainting, and mortal heat stroke. Heat stress (when the body is unable to rid itself of excess heat) is also typically associated with dehydration, which increases cardiovascular strain and reduces perceptual, cognitive, and physiological function and work performance1.
We believe heat stress may also have long-lasting health effects. During the last decades, epidemics of fatal CKDu, not related to diabetes, hypertension or other well-characterized etiologies, have emerged among laborers in tropical climate, including the Americas, India, Sri Lanka, and Egypt2. There is growing evidence that strenuous work in heat without sufficient rest or hydration is a driver of the disease3. Manual cane cutters have deteriorating renal function over a harvest period5, and cross-shift changes have been repeatedly observed4. Both acute kidney injury (AKI) and chronic kidney disease substantially increase the likelihood of illness and death. CKD has no cure and treatment options (dialysis or transplantation) are not viable in developing countries. The disease is likely multifactorial, but if heat stress is the underlying or exacerbating risk factor, it is possible to prevent the disease, or at least slow its progression, via a workplace intervention.
1. Lucas et al 2014
2. Wegman et al 2015
3. Correa-Rotter 2014, Roncal-Jimenez 2016
4. García-Trabanino 2015
5. Wegman et al 2017