Blog entry by Meguid El Nahas

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by Meguid El Nahas - Thursday, 1 September 2016, 11:10 AM
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http://www.ncbi.nlm.nih.gov/pubmed/?term=glaser%2C+lemer%2C+johnson

A review published in the August issue of cJASN argues for a Heat Stress Nephropathy (HSN) associated with Global warming...

It would involve a variety of incidences of renal impairment in countries such as El Salvador/Central America (Mesoamerican nephropathy, Sugar cane Nephropathy), Sri Lanka and India.

The review implicates global warming, dehydration, nephrotoxins as well as heavy metal contamination of drinking water, not to mention the ever present hyperuricemia and also hypokalemia as well as fructose toxicity...

Comments

The reality is that agriculture workers working unprotected for extremely long hours in extreme heat are simply prone to dehydration...

Longterm dehydration leads to longterm activation of the renin angiotensin aldosterone system (RAAS) that leades to chronic hypokalemia; severe dehydration along with chronic hypokalemia (observed in many of these workers) is enough to cause impaired renal function in anybody...

So rather than calling these conditions fancy names, it suffices that we acknowledge that dehydration is not good for the kidneys...and that adequate hydration is essential for workers of any type in any country working under extreme heat conditions!

Nephrologists love to come up with new "Nephropathies", it gives them a claim to have "discovered" and labelled an entity, even when it is as mundane as dehydration...and hypokalemia!

Some recent examples of labelling...

Warfarin nephropathy: Basically raised serum creatinine in sick and multi-comorbidities, over anticoagulated, patients with CVD...causal link with warfarin unproven!

Smoking Nephropathy: Basically CKD in heavy smokers...with multiple comorbidities and underlying CVD...

Mesoamerican nephropathy: Dehydration in agricultural workers...

Sugar Cane nephropathy: Dehydration in agricultural workers...(not just sugar cane), affecting those working a low altitude and not the cooler higher altitude farmers...

Fructose nephropathy, Uric Acid Nephropathy, etc...

In the case of "Heat Stess Nephropathy"...it would better be called Dehydration induce kidney failure...its prevention in adequate hydration and better working conditions of those exposed to hot climate...it treatment is re-hydration before long term damage takes place!

Lets keep the simple, simple and make its prevention and management equally simple.

As to Global Warming...thats better left to geographers and politicians...

[ Modified: Thursday, 1 January 1970, 1:00 AM ]