In my defence this from TFA: Much like public debates over climate change, discussions about the role of heat stress in CKDu can be contentious. Some close obs

In my defence this from TFA: Much like public debates over climate change, discussions about the role of heat stress in CKDu can be contentious. Some close observers, such as Glaser, have argued that heat alone is sufficient to cause CKDu. His stance has been bolstered by the success of interventions that encourage sugarcane cutters to rest more often in the shade and stay hydrated. Such measures have slashed rates of kidney injury among workers. Yet other experts, including Fischer, aren’t convinced. Fischer doesn’t doubt that heat is involved, only that it’s the sole cause. She cites findings from studies that were unable to conclusively rule out pesticides, heavy metals, and other environmental conditions as factors. And some of the highest rates of CKDu in Central America are among shrimp farmers, for whom heat stress is far less of an issue than it is for sugarcane cutters. She says high temperatures and dehydration likely amplify kidney damage from other contributors. “I think the role of heat is a complicating factor. It complicates whatever the disease pathology or physiology is,” she says. “I don’t think it’s a disease initiator.”