In Nicaragua and El Salvador, age-adjusted mortality rates from kidney disease are among the highest in the world. According to researchers, in these countries, the prevalence of kidney disease in affected communities is with age-specific rates among younger men up to 15 times higher than in the United States. At least 20,000 people are estimated to have died of chronic kidney disease (CKD) in Central America in the last 20 years alone, and many are sugar cane workers along the Pacific coast. Thousands of farmers have suffered from a disease that destroys their kidneys. Their eyes can become yellow, their bodies swollen and their muscles continuously cramping as their kidneys become irreversibly damaged leading to death. In the municipality of Chichigalpa, often called the ‘Isle of Widows,’ the disease is responsible for almost half of male deaths in the last decade. Many sick men facilitate their deaths by continuing to work in secret to help support their families. Sadly the town is fast becoming a land of widows. The epidemic of kidney disease among young Central American agricultural workers may be the result heat stress and volume depletion, according to new research published recently in the National Kidney Foundation’s American Journal of Kidney Diseases.