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[Texas Doctors Warn: Chronic Kidney Disease of Unknown Cause (CKDu) May Be Spreading in the US, Young Men Facing Organ Failure] (1) Doctors in Texas say an increasing number of previously healthy young men are seeking treatment for organ failure. Medical staff believe the culprit is CKDu, or Chronic Kidney Disease of Unknown Cause, a rapidly fatal kidney disease with an unclear cause. (2) Also known as Central American nephropathy, the disease is common in Central America and has been found in Sri Lanka. Researchers are concerned that it is spreading in the United States, especially among agricultural workers and manual laborers. (3) CKDu patients do not have typical kidney disease risk factors such as hypertension or diabetes. Most are Latino men aged 20 to 60 who often work in extreme conditions. Studies speculate that it is related to occupational and environmental exposure, especially among young men in lowland agricultural environments, such as sugarcane harvesters; another hypothesis is extreme heat stress or chronic dehydration, but the origin remains a "mystery to be solved." (4) In endemic areas, CKDu has a severe impact. The International Society of Nephrology stated that hospitalizations for this disease in El Salvador increased by 50% between 2005 and 2012, becoming the leading cause of hospitalization, with many hospitalized patients being under 19 years old. (5) CKDu is often only discovered in its late stages, when the kidneys are close to failure. Patients require dialysis or transplantation to survive, but the most vulnerable groups may not have access to these options. Researchers at Boston University stated that undocumented immigrants in most U.S. states do not have access to regular outpatient dialysis and can only rely on emergency dialysis; these cases are also not reported in the national kidney system database, and existing data likely underestimate the true burden of unexplained end-stage renal disease.