Kidney Disease With No Known Cause Is Turning Up in Young Texas Farmworkers

Doctors at Houston safety-net hospitals, including Ben Taub, have treated otherwise healthy men in their 20s and 30s who showed up with kidney failure and, in some cases, "Coca-Cola-colored urine," according to reporting cited by Fox News Digital and Texas Monthly. None had the usual risk factors: no diabetes, no high blood pressure, no glomerulonephritis.

The condition is called chronic kidney disease of unknown etiology, or CKDu. In Central America it's known as Mesoamerican nephropathy, first described among sugarcane harvesters in El Salvador and Nicaragua in the late 1990s, according to Dr. Gokul Paidi, a family medicine physician at Community Healthcare Network in New York who has published a review on the disease.

"It typically strikes young to middle-aged adults, more often men, who work in agriculture and manual labor in hot, low-resource regions," Paidi told Fox News Digital. He said the disease "often progresses rapidly over a few years, and dialysis and transplantation are rarely available" in the regions where it's endemic.

A Global Pattern, Not a New One

CKDu isn't confined to Central America. Paidi pointed to similar regional kidney disease clusters going back decades: Balkan endemic nephropathy since the 1950s, Itai-itai disease in Japan tied to cadmium-contaminated rice, and Sri Lanka nephropathy studied since the 1990s. Cases have also been reported in India, rural Thailand and the Tierra Blanca region of Mexico.

"What's emerging is that these are likely related conditions, essentially clusters of the same underlying disease process showing up in different farming and industrial regions around the world," Paidi said.

Epidemiologist Rebecca Fischer told Texas Monthly, as cited by The Hill, that researchers still don't have a firm answer on what's driving it. "We are quite far, still, from understanding exactly what's going on," she said. One 2024 research article floated extreme heat stress or chronic dehydration as a possible mechanism, and a 2023 public health journal hypothesized links to occupational and environmental exposures common among sugarcane harvesters. Neither explanation is confirmed.

The Scale of the Problem Where It's Endemic

In El Salvador, hospitalizations for CKDu rose 50% between 2005 and 2012, making it the leading cause of hospitalization in the country, according to the International Society of Nephrology. Many of those hospitalized were under 19 years old. The disease is often not diagnosed until kidneys are near failure, at which point patients need dialysis or a transplant just to survive.

Why the U.S. Numbers Are Probably Undercounted

Researchers at Boston University noted that undocumented immigrants in the United States generally cannot access routine outpatient dialysis in most states and instead rely on emergency dialysis through hospital ERs. Those emergency cases don't get reported into the national renal disease database, which means existing data "likely underestimates the true burden of unexplained ESKD" — end-stage kidney disease.

A disease outbreak that isn't being fully tracked because the patients most likely to have it are the least likely to show up in the formal healthcare and surveillance system creates a policy challenge. Emergency rooms, largely funded by taxpayers through uncompensated care pools, are absorbing costs for a chronic condition that would be cheaper to manage with regular outpatient treatment.

One pushback to framing this story around immigration status: it risks turning a medical mystery into an immigration talking point, when the underlying disease appears to be occupational and environmental, tied to heat and manual labor conditions that would affect any worker, citizen or not, doing the same job. The CDC and researchers cited above describe CKDu as an occupational health issue first, not an immigration issue. The healthcare-access gap is a separate, downstream problem about how the U.S. system handles chronic disease in a population that avoids routine medical contact.

What's Still Unknown

Texas Standard, in coverage from Houston-based journalist Mariana Hernandez broadcast September 3, described CKDu as a "growing health crisis" creating difficult choices for migrant patients and their families, particularly around dialysis access. That framing lines up with the clinical reporting from Fox News Digital and the data gaps flagged by Boston University researchers.

What none of the coverage answers yet: how many CKDu cases actually exist in Texas right now, whether Ben Taub's cases represent an isolated cluster or the leading edge of a broader pattern, and whether Texas or federal health agencies plan any formal surveillance effort to track it. No state or federal agency has announced a CKDu-specific reporting requirement or investigation as of this writing. Until one does, the true scope of the disease in American farmworkers will remain a mystery to solve.