A mysterious kidney disease has arrived in Texas

80 pointsposted 10 hours ago
by johntfella

75 Comments

anenefan

9 hours ago

I wasn't able to beat the bot wall, but I assume story close to [1] The thing of it is I'm aware of something very much the same - heat related kidney damage - something when I got a casual job with construction back in 2005, within the first couple of weeks I was warned rather pointedly by another worker who'd spent most of his working life around concreting and construction, of the dangers of long hours spend slouched over working on the concrete slabs. He had known many who'd got very ill despite following good hydration protocols [2], and knew working in the heat out on the slab came with this real risk. I being a new chum was dressed in heavy full length clothing, he generally wore cooler clothing - light shorts and short sleeved shirt which wasn't protocol for the job.

[1] https://www.linkedin.com/posts/davereddick_mysterious-kidney...

[2] Most labouring job sites I've been at in the 00s at least always had a very prominent chart regarding urine colour and the dangers of dehydration, and heat stroke. As such most workers at various sites I've worked at being much more aware of urine colour regarding dehydration than most of the medical staff I encountered at the hospital my Mum died in.

Edit: Forgot to mention my locale is North Queensland Australia - it gets fairly hot though summers.

conductr

7 hours ago

I’m in Texas and am around construction. The Mexican dudes can go all day with very little water. They tease my for my hydration and I’m not working half as hard as them. Then I see the urine they leave behind (usually left in drink bottles) and it makes my kidneys hurt.

Also if I don’t hydrate enough in this heat abd am really working then my kidneys literally hurt. It’s my reminder to stop and take a drink. I’ve been working outside a lot this summer and notice it’s much easier to get to that point when it’s over 105F. This summer has been a hot one even for Texas.

Anyways, there’s a cultural machismo amongst the Hispanic laborers that hydration is for putos. They do this with gloves too. I’ll offer gloves when handling materials and they always laugh and say no. Like their calluses hands are their resume. I have soft doctor like hands with no calluses so I do nothing without gloves.

kotaKat

4 hours ago

Feels like they're just trying to Any% a bad rhabdo run.

I'm reminded of something someone'd said regarding PPE:

Who cares what a bunch of other construction dudes think about your hard hat anyway? Some people are just going to be stubborn about any change, no matter what it is. Your family doesn't give a shit what you look like at work. They give a shit that you come home in one piece. Your family would rather they didn't need to change your diapers and feed you with a spoon because some of your coworkers thought the new safety gear looked weird.

user

2 hours ago

[deleted]

salawat

6 hours ago

Take care of yourself. Wear PPE, do your job right, work smarter, not harder. Your body will thank you in the long run. And for the love of all that is holy, invest in some thermal PPE. You will be amazed how deleterious extreme heat (104+) is to your mental acuity. This is not anecdata, it is fact. Phase Change Materials are the latest I've heard of in the field, and most operations don't seem to spring for them for employees. Do yourself the courtesy of getting some and set up your own safety program. If your boss and coworkers laugh at you, screw em'. You'll pay off in the long run by catching things everyone else is too heat drunk to have noticed.

https://www.mscdirect.com/knowledge-center/articles/cooling-...

Your bosses will never have as much of a stake in you as you do. Be your own advocate.

wlesieutre

9 hours ago

Can’t help that the state government is actively undermining local protections for workers dealing with heat dangers

https://www.texastribune.org/2023/06/16/texas-heat-wave-wate...

lukan

7 hours ago

"The law will nullify ordinances enacted by Austin in 2010 and Dallas in 2015 that established 10-minute breaks every four hours so that construction workers can drink water and protect themselves from the sun"

Wow, that is the absolute bare minimum and they even remove that.

tmnvix

5 hours ago

The really nasty bit is that taking the time to drink some water or apply sunscreen is considered a break and not just part of the bloody job. What's next? Standing up to stretch?

spiderfarmer

8 hours ago

The government in the US isn’t for the people.

N_Lens

7 hours ago

The government in the US is for people (corporations).

sneak

7 hours ago

No government in any place is for the people that aren’t the people that comprise the government.

They will, of course, all tell you otherwise.

spiderfarmer

3 hours ago

I drove over a perfectly paved road today.

My wife went to a hospital that was run perfectly. No charge.

The food I ate today was safe.

There's almost no criminal activity here.

We do not have any active wars.

DivingForGold

43 minutes ago

No criminal activity ?

Yeah, I have wandered mistakenly into the backstreets of Amsterdam and been approached by drug dealers.

sneak

2 hours ago

Do you live in Singapore, which this set of items perfectly describes? In Singapore, the state decides what media you are allowed to receive, to preserve the continuity of the state at your expense. In Singapore, you can be jailed for displaying certain flags.

The list you gave doesn’t refute my point in any way whatsoever.

How many paved roads and public hospitals does it take to offset a government depriving you of human rights to protect the state itself?

spiderfarmer

2 hours ago

The Netherlands. I’m alive thanks to the policies of the government. I don’t mind investing time, money and effort in a well run society. A better society starts with you.

kakacik

6 hours ago

Switzerland? Singapore? Japan? Bhutan?

Islands of prosperity in general.

TitaRusell

an hour ago

No country started out as an island of prosperity. They got there through hard work, sensible decision making and yes a little luck.

When in the 16th century all of Europe got involved in religious wars a Dutch leader decided that religion was a personal choice. This was not magic everyone could have come to this conclusion. But noone did.

ra

7 hours ago

except maybe Japan?

paulcole

9 hours ago

> I wasn't able to beat the bot wall

Most people have access to at least one 16-digit code that will do the trick.

anenefan

8 hours ago

Well what that 16 digit code might be I am unaware. I used to be able to unpick java based stuff to bypass walls but these days I really just don't try too hard, typically a site these days isn't a single site but uses other external services - I have many such services denied for scraping PII needlessly.

I could try a different browser - but in the time I wait for the site to decide if I'm not a bot, if I'm that invested, I've already done a quick search of topic heading and ...

creativeSlumber

7 hours ago

> Researchers had found signs of CKDu outside Central America, including in Sri Lanka, India, and Nepal. But it had never been documented in the United States.

I searched a bit more and found this interesting bit from an article talking about a similar epidemic in Sri Lanka.

> An analysis showed that trace metal ions such as calcium and magnesium that naturally occur in the hard water reacted with glyphosate. This meant that, instead of breaking down rapidly, glyphosate was able to persist in the environment for up to seven years in water and twenty-two years in soil.

https://www.thinkglobalhealth.org/article/mysterious-kidney-...

declan_roberts

6 hours ago

We should be seeing it all over America in that case.

cyberax

6 hours ago

> This meant that, instead of breaking down rapidly, glyphosate was able to persist in the environment for up to seven years in water and twenty-two years in soil.

Bulllshiiiitttt. There are no reputable studies that show anything like this.

ggm

9 hours ago

A disease which targets latinx? seems more likely its field workers, inadequate hydration and bad fluid hygene overall.

Could be culturally diet influenced as well.

My urologist after I had my first oxalate kidney stone said "you can drink a litre of water a day, or you can pay for my yacht upgrade. It's your choice" -but the main thing was to limit oxalate rich foods or take adequate citric acid alongside/soon after. Obv there are many kinds of kidney disease aside from stones, but the commonality here about 'use it or lose it' with heat, fluids, work strikes me.

tptacek

9 hours ago

Hard to imagine a diet of cultural significance that would put people into lifelong dialysis, at an epidemic scale.

riffraff

8 hours ago

Well there's cases of diets which came to prominence and caused issues,.from the obesity epidemic of modern west to the pellagra-riddled European countries consuming maize.

It is conceivable that social/natural changes might bring to dietary changes whose damage at scale is only visible on hindsight.

nine_k

9 hours ago

A diet that makes a particular infection easier to take root is very imaginable.

bawolff

9 hours ago

sure, but not if we are just suddenly seeing it now. Most cultural based diets have a long history.

masklinn

8 hours ago

They do, but it does not take much for economic pressure to make one seemingly small change with wide ramifications e.g. a plant or two which are not economically viable, get substituted, and turn out to be critical, then leading to chronic deficiencies (iirc the British navy got scurvy back after they switched from lemons to cheaper limes, or maybe between two kinds of limes and one had significantly lower levels of vit c).

It could also be interactions between the cultural diets and new products historically unavailable to that culture, which are either improperly processed (maize caused a lot of pellagra in europe) or has problematic interactions with components of the cultural diet (I don’t have an example for that, but grapefruit is famous for its medical interactions so nutritional interactions don’t seem impossible).

I don’t think it should be the first thread of investigation but it certainly should not be dismissed out of hand if nothing else bears fruit. That is how you get scurvy.

Someone

2 hours ago

> but not if we are just suddenly seeing it now

FTA: “Fischer and her collaborators combed through the medical records of patients who had received emergency dialysis between 2012 and 2015 at any Harris Health hospital. Out of the 346 cases of kidney failure in uninsured or undocumented patients, 17 percent had no readily identifiable cause. That percentage was staggering to the researchers. It suggested that thousands of emergency-dialysis visits in Texas annually may be attributable to CKDu“

⇒ it seems (part of) the reason we suddenly started seeing this is that we recently started looking for it.

user

6 hours ago

[deleted]

Hnrobert42

4 hours ago

I appreciate the attempt to be gender neutral, but it turns out that Latinos themselves generally do not prefer the term Latinx.

https://en.wikipedia.org/wiki/Latinx

mapotofu

2 hours ago

I think you’re being generous because I find this behavior quite disrespectful. Presumably they did so to signal and then talk about themselves.

phyzome

9 hours ago

For your explanation to be correct, you'd have to explain why this doesn't affect field workers of other genetic background all around the world.

throwup238

9 hours ago

It does. This article is about Latino workers but there are well known hotspots for CKDu in Sri Lanka and India. There’s other reports of it in the rest of Asia, Middle East, and Africa but its not as well known of an issue and under reported.

kulahan

6 hours ago

I feel like this is the medical equivalent of saying "I can't believe these guys didn't try turning it off and on again".

Like, "maybe the people whose job is to consider the cause and spread of disease never considered diet and hydration!"

ggm

6 hours ago

Yes, that occurred to me after I posted. Obviously they believe strongly there's some novel causes at play. Soil borne bacteria, fungi/mould, pesticide, genetics. They wouldn't publish otherwise. And, given climatic shifts we're already seening effects like zoolnotic disease movement so it could be parasite migration too. We've had odd pockets of diseases cropping up like malaria at European airports because of surviving mozzie infestations on inbound flights, and zika happened.

ggm

6 hours ago

In my defence this from TFA:

Much like public debates over climate change, discussions about the role of heat stress in CKDu can be contentious. Some close observers, such as Glaser, have argued that heat alone is sufficient to cause CKDu. His stance has been bolstered by the success of interventions that encourage sugarcane cutters to rest more often in the shade and stay hydrated. Such measures have slashed rates of kidney injury among workers. Yet other experts, including Fischer, aren’t convinced.

Fischer doesn’t doubt that heat is involved, only that it’s the sole cause. She cites findings from studies that were unable to conclusively rule out pesticides, heavy metals, and other environmental conditions as factors. And some of the highest rates of CKDu in Central America are among shrimp farmers, for whom heat stress is far less of an issue than it is for sugarcane cutters. She says high temperatures and dehydration likely amplify kidney damage from other contributors. “I think the role of heat is a complicating factor. It complicates whatever the disease pathology or physiology is,” she says. “I don’t think it’s a disease initiator.”

card_zero

9 hours ago

What's the popular food that contains lots of oxalates? I don't see anyone binging on sorrel or star fruit or parsley.

christophilus

9 hours ago

It’s in loads of things. Peanuts, spinach, beans, chocolate, avocados, corn, soy… the list is endless. If someone is really sensitive, they can have problems with high oxalate foods. Some people seem to accumulate oxalates, meaning their problems compound, where others have no problem at all. Biology is weird.

randcraw

an hour ago

It turns out that some foods counteract the formation of kidney stones. If you drink milk when you eat oxalates, the oxalates will not fuse into stones and will be excreted normally in your urine.

Oxalates are present in tea too, though not coffee, IIRC.

nine_k

9 hours ago

Spinach. Many nuts, e.g. almonds. Many beans (including cocoa but excluding coffee). Well, potatoes!

thelastgallon

9 hours ago

Spinach. Maybe other leafy vegetables.

4lx87

9 hours ago

Spinach is very high per serving, but all sorts of foods can have high oxalates per serving. Sweet potato, Swiss chard, almonds, beets, chocolate. You'd have to consult the content per serving for all foods you consume if you're trying to avoid them.

jrootabega

9 hours ago

Spinach and almonds.

card_zero

9 hours ago

I'm frequenting clinics

'Cos I eats my spinach,

I've kidney the failure, man

bsagdiyev

2 hours ago

Please do not refer to us as "latinx". That's disgusting.

GaryBluto

5 hours ago

>latinx

Is the LatinX the new release after the Latin8?

Cthulhu_

4 hours ago

It's white people virtue signaling and forcing ungendered words into a gendered language, see https://en.wikipedia.org/wiki/Latinx

> Latinx does not adhere to conventional grammatical gender rules in Spanish, is difficult to pronounce for Spanish speakers, and is criticized as showing disrespect towards the Spanish language as a whole.[1] In Latin America, terms such as Latine and Latin@ have been used to indicate gender-neutrality

WhereIsTheTruth

6 hours ago

> A disease which targets latinx? seems more likely its field workers, inadequate hydration and bad fluid hygene overall.

"has arrived"

Did working condition worsen over time? if yes, then maybe

If not, then COVID proved that we are past the idea of a theoretical biowar, it is already happening

orwin

4 hours ago

> Did working condition worsen over time? if yes, then maybe

I've read in this thread that Texas removed provisions for a mandatory hydration/sunscreen break after 4 hours of work.

bawolff

9 hours ago

Did these people never have a blood test/urine test prior to this? Normal Kidney disease should show up on tests long before the stage of collapsing.

I'm not a doctor, but if its sudden onset, all in a similar socio-economic-cultutal group, i would assume there was some sort of toxin they were all exposed to, perhaps at work.

TranquilMarmot

9 hours ago

I assume that they do not have regular access to medical care, especially if they are immigrant workers.

Anecdotally, I have chronic kidney disease that would not have shown up on routine bloodwork / urinalysis. Only after multiple acute episodes did I get a biopsy for a diagnosis, and even that took a year of bouncing between specialists in a big city with good healthcare.

trentor

9 hours ago

I get doing a blood panel once a year or so if you are not scraping by but never heard of doing a urine test without indication.

thaeli

8 hours ago

A routine urinalysis has always been part of my normal annual physicals.

cratermoon

8 hours ago

Bold of you to think undocumented workers making subsistence wages under a brutal system have access to annual physicals, much less the sort of continuously documented medical history needed to spot and address abnormalities before they become life-threatening emergencies.

stevenwoo

8 hours ago

It’s mentioned in the article it’s been documented in Central America for more than ten years in manual laborers but with few clues - possibly genetic predisposition combined with heat and physical exertion. It’s different types of manual labor so toxin exposure seems unlikely unless it turns out all of them got poisoned doing the same type of manual labor at one point and I would speculate they would have figured it out by now in Central America if it was toxin exposure.

https://www.npr.org/sections/goatsandsoda/2019/08/26/7538343...

sleepyguy

8 hours ago

Most of the roofers today in Texas are pretty damn young (16 - 30 tops). You don't really make it past that age because you're already worn out.

The crew (10 guys) that showed up to roof my house went through at least 5 cases of Gatorade, I have a fridge in the garage that I filled with drinks. I told them to help themselves after seeing them pull a hot bottle of water from one of the trucks. These guys didn't even have a cooler with cold water.

I suppose at some point water/hydration isn't good enough, they need salt and electrolytes to balance things out. They think wearing long pants and shirts acts as an insulator from the heat but in my opinion it's nuts, they need to cover up but, in the lightest possible clothing they can wear that breaths. The same goes for the landscapers who work outside all day. It wouldn't surprise me if they are dying from the heat, it is merciless here in the summer. Even the birds fly away....

Brybry

5 hours ago

OSHA has a proposed heat injury prevention rule that would make 80F (heat index) and 90F (optionally 95F, heat index) as initial and high heat trigger temperatures.

With the initial heat temperature, workers would need to be provided water and a break area that's shaded or air conditioned (it can also have a fan but employers must evaluate that the fan is used at the appropriate temperature and humidity and not cooking or dehydrating people). Interestingly the CDC warns not to use fans above 90F, which is much lower than the ~102F limit OSHA suggests. [1][2][3]

With high heat temperature, 15 minute breaks in the cooling area are required every 2 hours along with some buddy system/monitoring requirements. [4]

The notice of proposed rulemaking has a wealth of interesting study citations for risks (including kidney health issues) and risk reduction but it's a lot to even skim through.

I think a systematic review they cited suggested "hats; loose fitting, light/brightly colored/reflective, breathable, clothing; ventilation patches in PPE" for optimal clothing. But I do wonder if optimal clothing might vary based on temperature and humidity.

As a Louisianian, I don't know how the roofers do it. Sometimes it's so hot and humid it's rough to breathe outside just standing doing nothing.

[1] https://www.federalregister.gov/d/2024-14824/p-2907

[2] https://www.federalregister.gov/d/2024-14824/p-596

[3] https://www.cdc.gov/heat-health/about/index.html

[4] https://www.federalregister.gov/d/2024-14824/p-2932

EA-3167

9 hours ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC11093537/

The best guesses are both chronic rather than single acute injuries. High heat, dehydration, hard work, exposure to nitrites and who knows what else.

It’s mysterious because the specific etiology is unclear and therefore hard to prevent, since telling field workers not to work in the heat will be ignored by all involved.

junofan

6 hours ago

Check the references. They’re weak, almost ouroboric.

I found this: (2010) Positive association of renal insufficiency with agriculture employment and unregulated alcohol consumption in Nicaragua

https://doi.org/10.3109/0886022X.2010.494333

Essentially moonshine consumption.

Interestingly drinking more water was associated with worse outcomes. I would hesitate to point to dehydration without evidence, as a harmful remedy is worse than doing nothing.

Moonshine consumption could probably be investigated further as it carries explanatory power.

profsummergig

9 hours ago

are these the same workers who pluck vegetables while they're being sprayed with pesticides and herbicides?

b112

7 hours ago

I hope not, as every pesticide spray I know cannot be used near harvest time.

soulofmischief

7 hours ago

I worked on a small organic farm and I can attest that glyphosate was sprayed irregardless of season, because technically an adjacent unused field isn't the same field being harvested. However I can also attest to strong winds that easily carry nebulized particles across fields. I also fondly remember being provided no PPE and breathing in clouds of that shit and getting it all over my skin frequently.

b112

5 hours ago

That seems... unpleasant, and a good poit to make.

bamboozled

9 hours ago

I wonder if this is what regulations were for?

doc_ick

9 hours ago

Don’t worry, raw milk will save the day

*they said crying

zahlman

4 hours ago

What are you even talking about?

user

19 minutes ago

[deleted]