This talk draws from a book in progress on how residents living in the environs of a Nicaraguan sugarcane plantation have confronted a novel epidemic of chronic kidney disease. Most people in the area believe that the environmental conditions of cane production are linked to the disease, but clear evidence has been elusive. The chapter shows how, for residents of the sugarcane zone, the embankments of irrigation canals, dams, and pipes, as well as beaches and riverbeds, became effective places not just for producing evidence of the impact of sugar production on kidneys but also for flipping the terms on which kidney disease could be framed—from a disease of agricultural production to a disease of social reproduction. Questions about the distribution of water, as well as its quality, highlighted how the work of supporting the life of sugarcane became problematically at odds with that of supporting the lives of others who called the sugarcane zone home. Ethnographically, the talk links the kidney's primary biological function, cleansing the body of wastes, to the social acts of cleaning that took place along these embankments.