Heat-induced kidney disease: Understanding the impact

Area of Science:

• Environmental Health
• Occupational Medicine
• Nephrology

Background:

• Mesoamerican Nephropathy (MeN) and chronic kidney disease of unknown/nontraditional cause (CKD-UT) affect thousands of manual laborers.
• The disease impacts agricultural workers, particularly in heat-stressed environments, and has been observed globally.

Purpose of the Study:

• To review the evidence for causative factors of MeN and CKD-UT.
• To evaluate the role of heat stress versus other proposed etiological agents.

Main Methods:

• Systematic review of existing research on MeN and CKD-UT.
• Analysis of epidemiological data and etiological evidence.

Main Results:

• Evidence strongly supports heat stress as the primary cause of kidney disease in affected populations.
• Associations between heat exposure and kidney damage are consistent, specific, and show dose-response relationships.
• Support for alternative causes like agrochemicals, water quality, infections, and heavy metals is weak.

Conclusions:

• Heat stress is the most convincing cause of Mesoamerican Nephropathy and similar kidney diseases.
• Improving working conditions with hydration, rest, and shade is beneficial.
• Global warming is projected to increase the number of individuals at risk.