Kidney disease is undoubtedly a growing problem throughout the world, with one out of 10 adults facing CKD at some point in their lifetimes. A puzzling development, however, has emerged in Peru where many cases of advanced kidney failure have been documented in a demographic not typically regarded as being at high risk for CKD; namely, young people.

 More than any other disease (with the exception of HIV) the specific type of CKD affecting these younger people, CKD from undetermined causes, or CKDu, is on the rise, already responsible for thousands of deaths each year and climbing. 

Experts have speculated that the cause is a combination of environmental pollutants and chronic exposure to excessive heat, which many of these young people deal with daily as agricultural workers. Still, any conclusive causes remain elusive and offer little solace for young adults facing life on dialysis. Filmmaker Ed Kashi, in conjunction with National Geographic, has been hard at work for the past several years chronicling the lives of young people suffering from CKDu. His journey has spanned the globe, with Kashi visiting locales as varied as India, Sri Lanka, Nicaragua and Peru, but the stories he’s witnessed are all frightfully similar with young patients facing chronic pain, anxiety and the dismal daily reality of CKDu. 

Kashi has become something of an expert on CKDu’s status as an international trend of sorts, having observed it in numerous different countries. Already responsible for over 20,000 deaths in Nicaragua since 2000, Kashi predicts Peru will be the next country to face a sharp spike in cases and attributes this to the excessively long hours many agricultural workers spend dehydrated and beleaguered by ridiculously high temperatures. Seeing this as a human rights issue, in addition to a health issue, Kashi insightfully called out the fact that, for many in power, a health crisis amongst workers pales in importance to having inexpensive labor generate an abundant supply of strawberries, tomatoes and the like. 

Without significant labor reform, many more cases are likely to arise and without greater attention being paid to what is truly both a health and humanitarian crisis, they’ll likely continue to result in dire outcomes.

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