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A mysterious kidney disease may be the first pandemic caused by climate change

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Climate change is expected to have devastating and tangible impacts on hundreds of thousands of people across the world. From exacerbating mental health problems to spreading infections diseases, doctors and researchers are sounding the alarm on a wide range of public health emergencies that are likely emerge amid warnings of intensifying heat waves, prolonged droughts and extreme floods.

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A mysterious form of kidney disease that has killed tens of thousands of agricultural workers around the world is just one of many ailments expected to worsen as a result of climate change, according to researchers at the University of Colorado School of Medicine.

In a recent article published in the New England Journal of Medicine, Dr. Cecilia Sorensen, an emergency medicine physician who also teaches at the University of Colorado School of Medicine, called this unexplained kind of kidney failure a “sentinel disease” in the era of climate change.

The disease, described as chronic kidney disease (CKDu), “grows with environmental exposures (to heat and humidity) that are directly influenced by climate change,” she said.

It has made kidney failure the second-leading cause of death in Nicaragua and El Salvador.

The disease was first reported in the 1990s, when sugarcane cutters who toiled in plantations in Nicaragua, El Salvador and Guatemala were filling up clinics with end-stage kidney failure. Many of these workers were seemingly healthy, often in their 30s and 40s. They didn’t have the typical causes of kidney failure, like high blood pressure or diabetes, or other factors that might explain why their kidneys were failing. As of 2012, the disease had killed an estimated 20,000 people.

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The disease’s presence is now “potentially global,” Sorensen said, noting similar disease patterns have been observed in North America, South America, the Middle East, Africa and India. It has also beset people who work outdoors in the United States, in places like Florida, California and Colorado’s San Luis Valley.

The “true global burden” of chronic kidney disease is unknown, however, “because affected areas tend to have a poor health infrastructure, which leaves cases undetected or underreported,” Sorensen said.

But as temperatures continue to rise, it’s likely this deadly disease will appear more frequently and devastate thousands of laborers worldwide. An estimated 125 million people were exposed to heat waves between 2000 and 2016, according to the World Health Organization, and this trend is expected to continue and to worsen.

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Nearly three decades after it was first discovered, doctors and researchers continue to struggle to unravel the clues behind this mysterious epidemic.

Climate change is just one of many theories behind what’s causing this deadly disease to devastate an increasing number of communities around the world. Some doctors and researchers have attributed the disease to heat stress and dehydration, while others have proposed a correlation to drinking water contaminated with heavy metals or pesticides. Earlier studies suggested homemade alcohol was the culprit.

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Though doctors and researchers continue to struggle to pinpoint the root of this mysterious epidemic, “What we do know for certain is that CKDu is related to heat exposure and dehydration,” Sorensen said, though she noted other factors may also contribute.

She explained it’s difficult to understand the lead cause of chronic kidney disease because conditions that are often exacerbated by heat exposure — like cardiovascular and respiratory disease, poor mental health and adverse birth outcomes — are often “erroneously reported as the primary diagnosis, which conceals the role of heat as an inciting factor.” As a result, almost all physicians have “likely cared for patients who were adversely affected by climate change,” she said.

To address chronic kidney disease and other climate-related diseases, health care providers will “have to integrate environmental information into clinical and public health practice and build robust early-warning systems focused on vulnerable communities and climate-sensitive diseases,” Sorensen said. “We believe physicians have the opportunity to change the course of the future.”

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“We are now living in an era when climate change is no longer a distant, existential threat,” she said. “It is happening now, and it is affecting human health in profound ways.”


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Legal battles sparked by Trump’s behavior could affect how the US government works for generations — long after his impeachment trial is over

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After the last Senate staffer turns out the lights, major questions remain to be decided outside of the Capitol about the limits of presidential power, the willingness of courts to decide political questions and the ability of Congress to exercise effective oversight and hold a president accountable.

Here are three of those questions.

What are the limits of presidential power?

First, the aggressive exercise of executive power by Trump has put this power under court scrutiny.

Trump’s vow to “fight all the subpoenas” breaks from the traditional process – negotiation and accommodation – that previous presidents have used to resolve disputes between branches of the government.

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Secret recording features Trump falsely claiming that weed makes people ‘lose IQ points’

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President Donald Trump falsely claimed that marijuana makes people "lose IQ points" in a secret recording released by indicted former Rudy Giuliani associate Lev Parnas.

Parnas released the recording, which captured more than one hour of conversation at a private donor dinner with Trump in 2018, to show that the president told him that he would fire then-Ukraine Ambassador Marie Yovanovitch. But the recording, which was apparently captured by Parnas' indicted associate Igor Fruman, also featured Trump discussing Kim Jong Un's golf game, the European Union trying to "screw the United States," the 2016 election . . . and his views on marijuana.

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Experts explain how Trump team’s defense against the Bolton bombshell is blowing up in the president’s face

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Should former National Security Adviser John Bolton testify in President Donald Trump's Senate impeachment trial? This question has loomed over the entire proceedings, given Bolton's key role in the events in question, but it garnered heightened urgency when a report broke recently in the New York Times revealing that the ex-Trump aide would likely confirm the core of the Democrats' case against the president.

It still seems Republicans may succeed in quashing any demands for witnesses like Bolton. But as Trump and his attorney responded to the release of Bolton bombshell, they actually strengthened the case for having him testify rather than weakening it. Even if the GOP successfully brings the trial to a swift close, their having accidentally strengthened the case for witnesses may hurt the legitimacy of the Senate's proceedings and undermined Trump's inevitable claims of exoneration.

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