A kidney disease epidemic has been raging in Central America and Mexico for two decades, and most people in the United States are completely unaware of the situation. Some estimate that 20,000 or more men who work in agricultural fields have suffered from kidney failure, even though they were at the prime of their life.

The mysterious condition has been given a name, Mesoamerican nephropathy. It used to be called chronic kidney disease of unknown cause (CKDu). Even though health care professionals know what to call it, the condition is still vexing on many levels. Compounding the frustration is the fact that the health care system in that section of the world still isn't developed enough to deal with the thousands of patients suffering from the last stages of kidney disease. The necessary dialysis machines and kidney transplants simply aren't available for those who are suffering.

While Mesoamerican nephropathy is common among sugar cane field workers, it isn't exclusive to them. Others who engage in serious manual labor outside on a daily basis and who live on the Pacific coast from southern Mexico and certain parts of Central America, have also developed the kidney condition.

One of the characteristic traits of Mesoamerican nephropathy is that those who suffer from it don't have diabetes or hypertension. That's unusual for end-stage renal disease patients, which caused medical researchers to start digging into the mystery. After several peer-reviewed studies were conducted, it became apparent that the condition was concentrated in certain areas of southern Mexico, Nicaragua, El Salvador, Guatemala and Costa Rica.

Many of the patients who have suffered from Mesoamerican nephropathy have one thing in common: they've worked all day in the hot sun, performing agricultural labor for years. The obvious factor that has been brought up in several studies is that the workers aren't staying properly hydrated, not just once in a while, but day after day. Some researchers feel that the condition is made worse by the workers taking nonsteroidal anti-inflammatories, such as aspirin, to cure the aches and pains of the hard manual labor.

Making Mesoamerican nephropathy even more frustrating is the fact that it seems to be localized to the Pacific coast. For example, chronic kidney disease is much higher in Nicaragua than in Cuba, where sugar cane is also a common crop. Researchers have theorized that everything from the presence of heavy metals in the soil to drinks with high fructose corn syrup that are commonly consumed by workers, and even chemicals used on the crops on the Pacific coast are creating the perfect conditions for the disease to flourish.

Mesoamerican nephropathy isn't only mystifying, it's ripping entire communities apart. In areas where agriculture workers make up the majority of the population, widowed women who have multiple small children to care for is now a common plight.