A Mysterious Kidney Disease Is Striking Farm Workers in Texas
A form of chronic kidney disease with no clear cause is increasingly showing up in Texas hospitals, and it's disproportionately affecting agricultural and manual laborers, many of whom are undocumented, according to a new health review.
Texas hospitals are reporting a rise in cases of chronic kidney disease of unknown origin, or CKDu, according to a review from Texas Monthly. A significant share of the cases are occurring in undocumented workers, many of whom avoid seeking medical care because of their immigration status, making the true scope of the problem difficult to measure.
What the Data Shows
One dataset cited in the review looked at Harris Health, the public health system serving Harris County, which includes Houston. Out of 364 emergency dialysis cases involving uninsured or undocumented patients between 2012 and 2015, 17% had no identifiable cause, such as diabetes or high blood pressure, the conditions typically behind chronic kidney disease.
Dr. Richard J. Johnson, an emeritus professor of medicine at the University of Colorado and a kidney disease expert, told Fox News Digital that while researchers don't yet know the exact cause of CKDu, they do know it's connected to intense heat exposure. The condition can present with fatigue, sleep disturbances and other signs of severe kidney disease, even in patients without the usual risk factors.
A Disease With a Global History
CKDu isn't new, though its appearance in Texas marks a troubling development for a condition long associated with other parts of the world. Dr. Gokul Paidi, a family medicine physician at Community Healthcare Network in New York who has published a review on the condition, said it typically strikes young to middle-aged adults, more often men, working in agriculture and manual labor in hot, low-resource regions.
The specific form now appearing in Texas is believed to be Mesoamerican nephropathy, first described among sugarcane workers in El Salvador and Nicaragua in the late 1990s. Paidi noted that several other regional kidney diseases have been documented over the decades, including Balkan endemic nephropathy, first observed in the 1950s, and Itai-itai disease in Japan, which was linked to cadmium-contaminated rice.
The Debate Over Water Breaks
The disease's emergence in Texas has drawn renewed attention to the state's 2023 repeal of local water-break requirements for outdoor workers. House Bill 2127, sometimes called the "Death Star" law, eliminated local ordinances in cities like Austin and Dallas that had required employers to provide 10-minute water breaks every four hours for outdoor laborers.
Supporters of the law argued it removed a confusing patchwork of local rules and gave employers flexibility to manage breaks based on individual job-site conditions. Critics, including Houston officials who filed a lawsuit against the law, argued it stripped protections from some of the state's most heat-vulnerable workers at a time of increasingly extreme temperatures. Fact-checkers have since noted that the law does not explicitly ban water breaks outright, but rather removes the local mandates requiring them, and there's no clear evidence most employers have stopped offering breaks as a result.
Why Experts Are Watching Closely
Experts caution that CKDu and other heat-sensitive illnesses could become more common as climate change drives more extreme temperatures, particularly among workers who already face limited access to health care. The condition's tendency to strike otherwise healthy adults without the standard risk factors makes it especially difficult for doctors to catch early, and workers who fear seeking care because of their immigration status may not be diagnosed until the disease has progressed significantly.
Public health researchers say more data is needed to understand exactly how many Texas workers are affected and what specific combination of heat, dehydration and labor conditions is driving the increase.
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