From the International Journal of Occupational and Environmental Health comes this article looking at Changes in kidney function among Nicaraguan sugarcane workers. The article is behind a paywall but according to the NPR article it exonerates the fertilizers and pesticides and adds to the data on chronic and recurrent dehydration as the culprit:

“But this new study casts doubt on that theory. It found that field workers whose primary jobs were spraying for weeds and pests (and who thus had the most contact with agricultural chemicals) had the least decline in kidney function over the course of the harvest.

The researchers also found that dehydration among workers with the most physically demanding job — cutting cane — could contribute to the illness.”

I found this bit interesting:

“Cutters who drank more of a generic energy drink while on the job had less of a drop in kidney function than co-workers who drank less of the beverage.”

If the energy drink is protective that seems to counter the fructose/uric acid hypothesis that Dr. Johnson was proposing in his article. This continues to be one of the most interesting stories in nephrology.