Duke researchers are uncovering a troubling connection between climate change and a global surge in chronic kidney disease (CKD), particularly among agricultural workers. Anna Strasma, a nephrologist studying kidney disease in Central America, has witnessed the devastating impact of extreme heat on farm laborers, many of whom work in temperatures exceeding 100°F. These conditions, combined with dehydration, pesticide exposure and heavy metals in drinking water, are contributing to a mysterious form of CKD not linked to diabetes or hypertension—with no known treatment.
The epidemic, first noted in the 1990s, is affecting farming communities across Central America, Sri Lanka, India and beyond. Nishad Jayasundara, a global environmental health expert at the Nicholas School of the Environment and the Department of Medicine, reports that in some Sri Lankan villages, 60% of residents suffer from kidney failure. Jayasundara’s research shows poverty and heat exposure are key predictors of disease, with the poorest workers most vulnerable.
Duke’s Environmental Exposures and Kidney Health group, in collaboration with investigators at the University of North Carolina at Chapel Hill and the National Institute of Environmental Health Sciences, is leading efforts to understand and address the crisis. In addition, Duke’s Heat Policy Innovation Hub is developing tools to help policymakers mitigate heat stress in vulnerable communities. READ MORE.
Inspired by childhood experiences, Anna Strasma, MD, MSc-GH, a nephrologist at Duke University School of Medicine, studies unexplained kidney disease among farm workers in Central America. Photo by Eamon Queeney/School of Medicine.