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Mesoamerican nephropathy

Alejandro Riefkohl, Oriana Ramírez-Rubio, Rebecca L Laws, Michael D McClean, Daniel E Weiner, James S Kaufman, Renee L Galloway, Sean V Shadomy, Marta Guerra, Juan José Amador, José Marcel Sánchez, Damaris López-Pilarte, Chirag R Parikh, Jessica H Leibler, Daniel R Brooks
BACKGROUND: Leptospirosis is postulated as a possible cause of Mesoamerican Nephropathy (MeN) in Central American workers. OBJECTIVES: Investigate job-specific Leptospira seroprevalence and its association with kidney disease biomarkers. METHODS: In 282 sugarcane workers, 47 sugarcane applicants and 160 workers in other industries, we measured anti-leptospiral antibodies, serum creatinine, and urinary injury biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and N-acetyl-D-glucosaminidase (NAG)...
February 17, 2017: International Journal of Occupational and Environmental Health
Julia Wijkström, Marvin González-Quiroz, Mario Hernandez, Zulma Trujillo, Kjell Hultenby, Anneli Ring, Magnus Söderberg, Aurora Aragón, Carl-Gustaf Elinder, Annika Wernerson
BACKGROUND: Mesoamerican nephropathy (MeN) is a chronic kidney disease affecting rural inhabitants in Central America. We have previously described the renal morphology in 8 patients from El Salvador. To confirm the renal pathology, we have studied kidney biopsies from patients with MeN in Nicaragua. Follow-up urine and blood samples from both biopsy studies were collected to investigate the natural history. STUDY DESIGN: Case series. SETTINGS & PARTICIPANTS: In the kidney biopsy study, 19 male sugarcane workers in Nicaragua with suspected MeN were investigated with questionnaires, kidney biopsies, and blood and urine analysis...
January 23, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Marvin González-Quiroz, Armando Camacho, Dorien Faber, Aurora Aragón, Catharina Wesseling, Jason Glaser, Jennifer Le Blond, Liam Smeeth, Dorothea Nitsch, Neil Pearce, Ben Caplin
BACKGROUND: An epidemic of Mesoamerican Nephropathy (MeN) is killing thousands of agricultural workers along the Pacific coast of Central America, but the natural history and aetiology of the disease remain poorly understood. We have recently commenced a community-based longitudinal study to investigate Chronic Kidney Disease (CKD) in Nicaragua. Although logistically challenging, study designs of this type have the potential to provide important insights that other study designs cannot...
January 13, 2017: BMC Nephrology
Carlos A Roncal-Jimenez, Tamara Milagres, Ana Andres-Hernando, Masanari Kuwabara, Thomas Jensen, Zhilin Song, Petter Bjornstad, Gabriela E Garcia, Yuka Sato, Laura-Gabriela Sanchez-Lozada, Miguel A Lanaspa, Richard J Johnson
BACKGROUND: Recurrent heat stress and dehydration have recently been shown experimentally to cause chronic kidney disease (CKD). One potential mediator may be vasopressin, acting via the type 2 vasopressin receptor (V2 receptor). We tested the hypothesis that desmopressin accelerates CKD in mice subjected to heat stress and recurrent dehydration. METHODS: Recurrent exposure to heat with limited water availability was performed in male mice over a 5 week period, with one group receiving desmopressin twice daily and the other group received vehicle...
December 21, 2016: American Journal of Physiology. Renal Physiology
Catharina Wesseling, Aurora Aragón, Marvin González, Ilana Weiss, Jason Glaser, Christopher J Rivard, Carlos Roncal-Jiménez, Ricardo Correa-Rotter, Richard J Johnson
OBJECTIVES: To study Mesoamerican nephropathy (MeN) and its risk factors in three hot occupations. DESIGN: Cross-sectional. SETTING: Chinandega and León municipalities, a MeN hotspot on the Nicaraguan Pacific coast, January-February 2013. PARTICIPANTS: 194 male workers aged 17-39 years: 86 sugarcane cutters, 56 construction workers, 52 small-scale farmers. OUTCOME MEASURES: (1) Differences between the three occupational groups in prevalences/levels of socioeconomic, occupational, lifestyle and health risk factors for chronic kidney disease (CKD) and in biomarkers of kidney function and hydration; (2) differences in prevalences/levels of CKD risk factors between workers with reduced estimated glomerular filtration rate (eGFRCKD-EPI <80 mL/min/1...
December 8, 2016: BMJ Open
Esmeralda Castillo-Rodriguez, Raul Fernandez-Prado, Catalina Martin-Cleary, Maria Soledad Pizarro-Sánchez, Maria Dolores Sanchez-Niño, Ana Belen Sanz, Beatriz Fernandez-Fernandez, Alberto Ortiz
The current categorization of chronic kidney disease (CKD) is based on biomarkers of the glomerular function (estimated glomerular filtration rate, eGFR) and injury (urinary albumin creatinine ratio, UACR) and provides information on the risk of death and of progression of kidney disease. However, there are gaps in knowledge regarding the risk stratification of elderly patients with eGFR 45-60 ml/min/1.73 m2 and of younger patients with higher eGFR but physiological albuminuria. In this regard, most of the kidney cell mass is composed of tubules...
October 22, 2016: Nephron
Joseph Kupferman, Juan José Amador, Katherine E Lynch, Rebecca L Laws, Damaris López-Pilarte, Oriana Ramírez-Rubio, James S Kaufman, Jorge Luis Lau, Daniel E Weiner, Ninoska Violeta Robles, Karina P Verma, Madeleine K Scammell, Michael D McClean, Daniel R Brooks, David J Friedman
BACKGROUND: Mesoamerican nephropathy (MeN) is a kidney disease of unknown cause that mainly affects working-age men in Central America. Despite being a major cause of morbidity and mortality in this region, its clinical characteristics have not been well defined. STUDY DESIGN: Cross-sectional family-based study. SETTING & PARTICIPANTS: 266 members of 24 families with high chronic kidney disease (CKD) burdens in a MeN hotspot in Northwestern Nicaragua...
November 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Ramón García-Trabanino, Zulma Trujillo, Ana Verónica Colorado, Salvador Magaña Mercado, Carlos Atilio Henríquez
El Salvador has the highest renal failure mortality rate in the Americas. Five healthcare providers offer renal replacement therapy (RRT) in the country. The national RRT prevalence has never been reported. AIMS: To determine the RRT prevalence in El Salvador and some basic characteristics. METHODS: The association of nephrology coordinated a nationwide cross-sectional survey during the third quarter of 2014. 31 renal centres participated in the survey, covering 99...
November 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Ramón García-Trabanino, Carolina Hernández, Adrián Rosa, Jesús Domínguez Alonso
The Bajo Lempa is an impoverished rural coastal region of El Salvador affected by the chronic kidney disease (CKD) epidemic known as Mesoamerican nephropathy. The local community organisation Fondo Social de Emergencia para la Salud (FSES) (Emergency social fund for health) is helping to fight the epidemic in 42 communities of the region (19,223 inhabitants; average age 26.7 years; 48.5% male; 40.2% <18 years). OBJECTIVES: To report annual rates of end-stage renal disease (ESRD) incidence and patient mortality in these communities during a 10-year period (2004-2013), and the prevalence of patients receiving renal replacement therapy (RRT) as of 31 December 2013...
September 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
Catharina Wesseling, Aurora Aragón, Marvin González, Ilana Weiss, Jason Glaser, Norma A Bobadilla, Carlos Roncal-Jiménez, Ricardo Correa-Rotter, Richard J Johnson, Lars Barregard
BACKGROUND: Chronic kidney disease is common among sugarcane workers in Central America. The main risk factor seems to be repeated high-intensity work in hot environments. Several cross-sectional studies have been performed but few longitudinal studies. OBJECTIVES: The aim of the study was to examine whether kidney function changes over a few months of work during the harvest period. METHODS: A group of male sugarcane cutters in Nicaragua (N=29, aged 17-38 years) was examined with renal biomarkers before and after shift on the first day at the start of harvest, on the sixth day during acclimatization, and then in mid-harvest 9 weeks later...
May 2016: Environmental Research
Catharina Wesseling, Ramón García-Trabanino, David H Wegman
No abstract text is available yet for this article.
February 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Vito M Campese
No abstract text is available yet for this article.
March 2016: Nephrology, Dialysis, Transplantation
Carlos A Roncal-Jimenez, Ramon García-Trabanino, Catharina Wesseling, Richard J Johnson
BACKGROUND: An epidemic of chronic kidney disease (CKD) of unknown cause has emerged along the Pacific Coast of Central America. The disease primarily affects men working manually outdoors, and the major group affected is sugarcane workers. The disease presents with an asymptomatic rise in serum creatinine that progresses to end-stage renal disease over several years. Renal biopsies show chronic tubulointerstitial disease. While the cause remains unknown, recent studies suggest that it is driven by recurrent dehydration in the hot climate...
2016: Blood Purification
Carlos Roncal-Jimenez, Ramón García-Trabanino, Lars Barregard, Miguel A Lanaspa, Catharina Wesseling, Tamara Harra, Aurora Aragón, Felix Grases, Emmanuel R Jarquin, Marvin A González, Ilana Weiss, Jason Glaser, Laura G Sánchez-Lozada, Richard J Johnson
Mesoamerican nephropathy (MeN), an epidemic in Central America, is a chronic kidney disease of unknown cause. In this article, we argue that MeN may be a uric acid disorder. Individuals at risk for developing the disease are primarily male workers exposed to heat stress and physical exertion that predisposes to recurrent water and volume depletion, often accompanied by urinary concentration and acidification. Uric acid is generated during heat stress, in part consequent to nucleotide release from muscles. We hypothesize that working in the sugarcane fields may result in cyclic uricosuria in which uric acid concentrations exceed solubility, leading to the formation of dihydrate urate crystals and local injury...
January 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Huang-Yu Yang, Cheng-Chieh Hung, Su-Hsun Liu, Yi-Gen Guo, Yung-Chang Chen, Yi-Ching Ko, Chiung-Tseng Huang, Li-Fang Chou, Ya-Chung Tian, Ming-Yang Chang, Hsiang-Hao Hsu, Ming-Yen Lin, Shang-Jyh Hwang, Chih-Wei Yang
BACKGROUND: Leptospirosis is the most widespread zoonosis. Chronic human infection and asymptomatic colonization have been reported. However, renal involvement in those with leptospira chronic exposure remains undetermined. METHODS AND FINDINGS: In 2007, a multistage sampling survey for chronic kidney disease (CKD) was conducted in a southern county of Taiwan, an area with a high prevalence of dialysis. Additionally, an independent cohort of 88 participants from a leptospira-endemic town was followed for two years after a flooding in 2009...
2015: PLoS Neglected Tropical Diseases
Kristy O Murray, Rebecca S B Fischer, Denis Chavarria, Christiane Duttmann, Melissa N Garcia, Rodion Gorchakov, Peter J Hotez, William Jiron, Jessica H Leibler, Job E Lopez, Sreedhar Mandayam, Alejandro Marin, Jessica Sheleby
An outbreak of unexplained and severe kidney disease, "Mesoamerican Nephropathy," in mostly young, male sugar cane workers emerged in Central America in the late 1990's. As a result, an estimated 20,000 individuals have died, to date. Unfortunately, and with great consequence to human life, the etiology of the outbreak has yet to be identified. The sugarcane fields in Chichigalpa, Chinandega, Nicaragua, have been involved in the outbreak, and during our initial investigation, we interviewed case patients who experienced fever, nausea and vomiting, arthralgia, myalgia, headache, neck and back pain, weakness, and paresthesia at the onset of acute kidney disease...
October 2015: Microbes and Infection
Ramón García-Trabanino, Emmanuel Jarquín, Catharina Wesseling, Richard J Johnson, Marvin González-Quiroz, Ilana Weiss, Jason Glaser, Juan José Vindell, Leo Stockfelt, Carlos Roncal, Tamara Harra, Lars Barregard
BACKGROUND: An epidemic of progressive kidney failure afflicts sugarcane workers in Central America. Repeated high-intensity work in hot environments is a possible cause. OBJECTIVES: To assess heat stress, dehydration, biomarkers of renal function and their possible associations. A secondary aim was to evaluate the prevalence of pre-shift renal damage and possible causal factors. METHODS: Sugarcane cutters (N=189, aged 18-49 years, 168 of them male) from three regions in El Salvador were examined before and after shift...
October 2015: Environmental Research
David Wegman, Jason Glaser, Richard J Johnson, Christer Hogstedt, Catharina Wesseling
No abstract text is available yet for this article.
2015: International Journal of Occupational and Environmental Health
Catharina Wesseling, Berna van Wendel de Joode, Jennifer Crowe, Ralf Rittner, Negin A Sanati, Christer Hogstedt, Kristina Jakobsson
OBJECTIVES: Mesoamerican nephropathy is an epidemic of chronic kidney disease (CKD) unrelated to traditional causes, mostly observed in sugarcane workers. We analysed CKD mortality in Costa Rica to explore when and where the epidemic emerged, sex and age patterns, and relationship with altitude, climate and sugarcane production. METHODS: SMRs for CKD deaths (1970-2012) among population aged ≥20 were computed for 7 provinces and 81 counties over 4 time periods...
October 2015: Occupational and Environmental Medicine
Jill F Lebov, Eliette Valladares, Rodolfo Peña, Edgar M Peña, Scott L Sanoff, Efren Castellón Cisneros, Romulo E Colindres, Douglas R Morgan, Susan L Hogan
BACKGROUND: Recent studies have shown an excess of chronic kidney disease (CKD) among younger adult males in the Pacific coastal region of Nicaragua and suggest a non-conventional CKD etiology in this region. These studies have been conducted in small, non-representative populations. OBJECTIVES: We conducted a large population-based cross-sectional study to estimate CKD prevalence in León, Nicaragua, and to evaluate the association between previously investigated risk factors and CKD...
2015: Canadian Journal of Kidney Health and Disease
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