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-...
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.
It is conceivable that social/natural changes might bring to dietary changes whose damage at scale is only visible on hindsight.
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.
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.
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.
https://www.npr.org/sections/goatsandsoda/2019/08/26/7538343...
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....
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.
[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.
https://www.texastribune.org/2023/06/16/texas-heat-wave-wate...
Wow, that is the absolute bare minimum and they even remove that.
Most people have access to at least one 16-digit code that will do the trick.
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 ...
They're probably talking about buying a subscription with a credit card, but I'm less certain where it lies on the shared-joke versus snide-insult spectrum.
That said, not all are 16 digits. [0]
[0] https://en.wikipedia.org/wiki/Payment_card_number#Issuer_ide...