Mysterious kidney disease strikes young Texas laborers, echoing Central American epidemic

A form of chronic kidney disease without known cause, previously documented among sugarcane workers in El Salvador and Nicaragua, is now appearing in Texas among young men employed in construction, roofing and other outdoor trades. Physicians at Houston safety-net hospitals have treated otherwise healthy individuals in their 20s and 30s who present with severe kidney failure, often described as having "Coca-Cola-colored urine."

The patients, largely undocumented migrants, lack conventional risk factors like hypertension or diabetes, and a review of Harris County records indicates that about one in six emergency dialysis cases in uninsured patients have no identifiable etiology, matching CKDu patterns. Researchers point to chronic heat stress, repeated dehydration, possible pesticide exposure and over-the-counter pain-killer use as likely contributors, though the precise mechanism is still unknown.

Diagnosis relies on ruling out other kidney diseases and considering occupational exposure, while treatment is limited to blood-pressure control, avoidance of further kidney injury and, in advanced stages, dialysis or transplantation. Early screening with blood creatinine and urine protein tests is recommended for workers in hot, low-resource environments.