Abstract
California’s Central Valley has one of the highest incidences of end-stage kidney disease (ESKD) in the United States. This region shares climate, topography, and agricultural activity with international regions experiencing epidemics of CKD among agricultural workers, termed chronic kidney disease of unknown etiology (CKDu). It remains unclear whether agricultural workers in California are also vulnerable to CKDu. In 2020 we demonstrated that areas with high numbers of people with undefined ESKD in California overlap with areas of high agricultural activity as measured by ground water nitrate (Figure 1).
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