A mysterious form of kidney disease that has devastated young agricultural workers in Central America is raising concerns among doctors treating otherwise healthy outdoor labourers in Texas.

Physicians at Houston safety-net hospitals, including Ben Taub, have reportedly treated otherwise healthy men in their twenties and thirties who arrived in kidney failure, some with Coca-Cola-coloured urine.

Mysterious Kidney Disease in Houston Hospitals

Texas Monthly described the Texas cluster on 31 August 2026, after Carrie Arnold found local studies while reporting the epidemic in Central America in late 2024.

The condition is known as chronic kidney disease of unknown aetiology (CKDu); the form associated with Central American agricultural communities is often called Mesoamerican nephropathy. It typically appears in working-age men doing heavy outdoor labour.

Early disease can produce few or no symptoms; fatigue and anaemia may appear as kidney function worsens. Many show no warning until they need dialysis three times a week.

A Harris County study found that roughly one in six emergency dialysis cases had no identifiable cause for their kidney disease. A 2025 analysis of 346 patients who needed emergency haemodialysis at a Harris County public hospital between 2012 and 2015 classified 58, or 17 per cent, as potentially CKDu-related end-stage disease.

CKDu is not contagious. CKDu refers to kidney disease that cannot be explained by traditional causes such as diabetes or hypertension. Heat stress and repeated dehydration are among the leading suspected contributors, but the disease appears to have multiple possible causes.

There is currently no established disease-specific cure, so treatment focuses on managing kidney disease, preventing further injury and treating complications.

From Cane Fields to Texas Heat

Researchers and clinicians began documenting unusual kidney disease among agricultural workers in Central America in the late 1990s and early 2000s.

The Pan American Health Organization estimated more than 60,000 renal failure deaths in Central America between 1997 and 2013, 41 per cent among people younger than 60. A 2019 PAHO figure put El Salvador's death rate at 67.4 per 100,000.

Dr Marvin Gonzalez-Quiroz, who first saw young patients fail in Nicaragua and later planned Texas fieldwork, has said repeated heat stress and dehydration in intense outdoor labour may lead to recurrent acute injury that 'gradually accumulates' into chronic disease.

A workplace prevention programme using rest, shade, water and electrolytes reduced cases of acute kidney injury by 94 per cent among sugarcane workers in Nicaragua, according to evidence cited in the ILO's 2024 heat-at-work report.

Jason Glaser of La Isla Network has asked why workers in a Nicaraguan field have better protections than a worker in Texas.

Why the Texas Cluster Is Hard To Track

Experts call CKDu a silent disease because most patients do not complain at first. Many Houston patients are undocumented migrants from Mexico and Central America and reach emergency rooms only when failure is established.

A 2022 pilot of 16 Texas construction workers found blood in the urine in about half and potential early kidney damage in 12 per cent. An analysis of OSHA records found 23 Texas workers with heat-related kidney damage.

The Texas cases under investigation resemble CKDu, but researchers have not established a single cause—or confirmed that every case represents the same disease process.

Outdoor labour in high heat links Houston emergency rooms to the cane fields of Bajo Lempa. A creatinine blood test and a urine protein check can help detect kidney damage early.

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