Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress Nephropathy
The beginning of the 21st century has seen the emergence of a new chronic tubulo-interstitial kidney disease of uncertain cause among agricultural communities in Central America and Sri Lanka. Despite many similarities in demography, presentation, clinical features, and renal histopathology in affec...
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doaj-ea77e4bbfdf74ea29202ccaf8e0343902020-11-24T23:06:26ZengElsevierKidney International Reports2468-02492018-03-013227128010.1016/j.ekir.2017.10.006Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress NephropathyChula Herath0Channa Jayasumana1P. Mangala C.S. De Silva2P.H. Chaminda De Silva3Sisira Siribaddana4Marc E. De Broe5Department of Nephrology, Sri Jayewardenepura General Hospital, Sri LankaDepartment of Pharmacology, Faculty of Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri LankaDepartment of Zoology, University of Ruhuna, Matara, Sri LankaDepartment of Meteorology of Sri Lanka, Colombo, Sri LankaDepartment of Pharmacology, Faculty of Medicine, Rajarata University of Sri Lanka, Saliyapura, Sri LankaLaboratory of Pathophysiology, University of Antwerp, Wilrijk, BelgiumThe beginning of the 21st century has seen the emergence of a new chronic tubulo-interstitial kidney disease of uncertain cause among agricultural communities in Central America and Sri Lanka. Despite many similarities in demography, presentation, clinical features, and renal histopathology in affected individuals in these regions, a toxic etiology has been considered mainly in Sri Lanka, whereas the predominant hypothesis in Central America has been that recurrent acute kidney injury (AKI) caused by heat stress leads to chronic kidney disease (CKD). This is termed the heat stress/dehydration hypothesis. This review attempts to demonstrate that there is sparse evidence for the occurrence of significant AKI among manual workers who are at high risk, and that there is little substantial evidence that an elevation of serum creatinine < 0.3 mg/dl in previously healthy people will lead to CKD even with recurrent episodes. It is also proposed that the extent of global warming over the last half-century was not sufficient to have caused a drastic change in the effects of heat stress on renal function in manual workers. Comparable chronic tubulo-interstitial kidney disease is not seen in workers exposed to heat in most tropical regions, although the disease is seen in individuals not exposed to heat stress in the affected regions. The proposed pathogenic mechanisms of heat stress causing CKD have not yet been proved in humans or demonstrated in workers at risk. It is believed that claims of a global warming nephropathy in relation to this disease may be premature and without convincing evidence.http://www.sciencedirect.com/science/article/pii/S2468024917304242chronic interstitial nephritis in agricultural communitiesCKDu in Sri Lankaheat-stress nephropathy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chula Herath Channa Jayasumana P. Mangala C.S. De Silva P.H. Chaminda De Silva Sisira Siribaddana Marc E. De Broe |
spellingShingle |
Chula Herath Channa Jayasumana P. Mangala C.S. De Silva P.H. Chaminda De Silva Sisira Siribaddana Marc E. De Broe Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress Nephropathy Kidney International Reports chronic interstitial nephritis in agricultural communities CKDu in Sri Lanka heat-stress nephropathy |
author_facet |
Chula Herath Channa Jayasumana P. Mangala C.S. De Silva P.H. Chaminda De Silva Sisira Siribaddana Marc E. De Broe |
author_sort |
Chula Herath |
title |
Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress Nephropathy |
title_short |
Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress Nephropathy |
title_full |
Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress Nephropathy |
title_fullStr |
Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress Nephropathy |
title_full_unstemmed |
Kidney Diseases in Agricultural Communities: A Case Against Heat-Stress Nephropathy |
title_sort |
kidney diseases in agricultural communities: a case against heat-stress nephropathy |
publisher |
Elsevier |
series |
Kidney International Reports |
issn |
2468-0249 |
publishDate |
2018-03-01 |
description |
The beginning of the 21st century has seen the emergence of a new chronic tubulo-interstitial kidney disease of uncertain cause among agricultural communities in Central America and Sri Lanka. Despite many similarities in demography, presentation, clinical features, and renal histopathology in affected individuals in these regions, a toxic etiology has been considered mainly in Sri Lanka, whereas the predominant hypothesis in Central America has been that recurrent acute kidney injury (AKI) caused by heat stress leads to chronic kidney disease (CKD). This is termed the heat stress/dehydration hypothesis. This review attempts to demonstrate that there is sparse evidence for the occurrence of significant AKI among manual workers who are at high risk, and that there is little substantial evidence that an elevation of serum creatinine < 0.3 mg/dl in previously healthy people will lead to CKD even with recurrent episodes. It is also proposed that the extent of global warming over the last half-century was not sufficient to have caused a drastic change in the effects of heat stress on renal function in manual workers. Comparable chronic tubulo-interstitial kidney disease is not seen in workers exposed to heat in most tropical regions, although the disease is seen in individuals not exposed to heat stress in the affected regions. The proposed pathogenic mechanisms of heat stress causing CKD have not yet been proved in humans or demonstrated in workers at risk. It is believed that claims of a global warming nephropathy in relation to this disease may be premature and without convincing evidence. |
topic |
chronic interstitial nephritis in agricultural communities CKDu in Sri Lanka heat-stress nephropathy |
url |
http://www.sciencedirect.com/science/article/pii/S2468024917304242 |
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