Clinical and Pathological Characterization of Mesoamerican Nephropathy: A New Kidney Disease in Central America

Wijkström, Julia; Leiva, Ricardo; Elinder, Carl‐Gustaf; Leiva, Silvia F.; Trujillo, Zulma; Trujillo, Luis Vidal; Söderberg, Magnus; Hultenby, Kjell; Wernerson, Annika

doi:10.1053/j.ajkd.2013.05.019

Cited by 167 publications

(193 citation statements)

References 30 publications

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“…38,39 Glomerulosclerosis secondary to proximal tubule injuries is also observed in clinical situations. Mesoamerican nephropathy 40 represents interstitial fibrosis and glomerulosclerosis after repeated episodes of AKI.…”

Section: Discussionmentioning

confidence: 99%

Severity and Frequency of Proximal Tubule Injury Determines Renal Prognosis

Takaori

Nakamura

Yamamoto

et al. 2015

JASN

203

167

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AKI increases the risk of developing CKD, but the mechanisms linking AKI to CKD remain unclear. Because proximal tubule injury is the mainstay of AKI, we postulated that proximal tubule injury triggers features of CKD. We generated a novel mouse model to induce proximal tubule-specific adjustable injury by inducing the expression of diphtheria toxin (DT) receptor with variable prevalence in proximal tubules. Administration of high-dose DT in mice expressing the DT receptor consistently caused severe proximal tubule-specific injury associated with interstitial fibrosis and reduction of erythropoietin production. Mild proximal tubule injury from a single injection of low-dose DT triggered reversible fibrosis, whereas repeated mild injuries caused sustained interstitial fibrosis, inflammation, glomerulosclerosis, and atubular glomeruli. DT-induced proximal tubule-specific injury also triggered distal tubule injury. Furthermore, injured tubular cells cocultured with fibroblasts stimulated induction of extracellular matrix and inflammatory genes. These results support the existence of proximal-distal tubule crosstalk and crosstalk between tubular cells and fibroblasts. Overall, our data provide evidence that proximal tubule injury triggers several features of CKD and that the severity and frequency of proximal tubule injury determines the progression to CKD.

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Section: Discussionmentioning

confidence: 99%

Severity and Frequency of Proximal Tubule Injury Determines Renal Prognosis

Takaori

Nakamura

Yamamoto

et al. 2015

JASN

203

167

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“…Clinically, the subjects are usually discovered with an asymptomatic rise in serum creatinine, in association with low grade or absent proteinuria, occasionally with microhematuria (36,37). Mild anemia, hypokalemia, and hyperuricemia are common (41)(42)(43). Renal biopsies show interstitial fibrosis, low grade inflammation, tubular atrophy, and extensive glomerulosclerosis with signs of glomerular ischemia but only mild vascular lesions (42,44).…”

Section: Mesoamerican Nephropathymentioning

confidence: 99%

“…Mild anemia, hypokalemia, and hyperuricemia are common (41)(42)(43). Renal biopsies show interstitial fibrosis, low grade inflammation, tubular atrophy, and extensive glomerulosclerosis with signs of glomerular ischemia but only mild vascular lesions (42,44). Progression to ESRD occurs over several years and is higher in those who work more harvests (32).…”

Section: Mesoamerican Nephropathymentioning

confidence: 99%

Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy

Glaser¹,

Lemery²,

Rajagopalan³

et al. 2016

CJASN

316

264

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Climate change has led to significant rise of 0.8˚C-0.9˚C in global mean temperature over the last century and has been linked with significant increases in the frequency and severity of heat waves (extreme heat events). Climate change has also been increasingly connected to detrimental human health. One of the consequences of climate-related extreme heat exposure is dehydration and volume loss, leading to acute mortality from exacerbations of pre-existing chronic disease, as well as from outright heat exhaustion and heat stroke. Recent studies have also shown that recurrent heat exposure with physical exertion and inadequate hydration can lead to CKD that is distinct from that caused by diabetes, hypertension, or GN. Epidemics of CKD consistent with heat stress nephropathy are now occurring across the world. Here, we describe this disease, discuss the locations where it appears to be manifesting, link it with increasing temperatures, and discuss ongoing attempts to prevent the disease. Heat stress nephropathy may represent one of the first epidemics due to global warming. Government, industry, and health policy makers in the impacted regions should place greater emphasis on occupational and community interventions.

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“…Studies from Central America have reported a new kidney disease Mesoamerican nephropathy which primarily affects agricultural communities especially in the sugarcane fields. 1,5,6 It was reported to present with mild proteinuria and asymptomatic progressive kidney failure. Kidney biopsies showed chronic tubulointerstitital disease with secondary glomerulosclerosis and some signs of glomerular ischemia.…”

Section: Discussionmentioning

confidence: 99%

“…In 2010, CKD soared to 18th place from 27 th in 1990 among global causes of mortality. 1 In the last two decades it has recorded the third largest increase in mortality (by 82%) after HIV/AIDS and diabetes. 2 Hypertension and diabetic nephropathy are the two most common diseases which lead to end-stage renal disease apart from obesity and metabolic syndrome which also frequently lead to early involvement of kidneys, even before diabetes and high blood pressure become apparent.…”

Section: Introductionmentioning

confidence: 99%

A study of chronic kidney disease patients with no known risk factors coming to tertiary care hospital

et al. 2017

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Background: Chronic kidney disease (CKD) has become a major cause of morbidity and. in some parts of the world CKD incidence has increased regardless of hypertension, diabetes mellitus or metabolic syndrome. This study was done to identify the unknown factors which can be contributing to the increased incidence of CKD. Methods: It was a case control study. There were 61 cases and 50 controls. A detailed history regarding residence, occupation, addiction, drug intake, family history, diet and environmental factors was taken. The data was analysed to identify a common factor amongst the CKD patients who did not have history of any known risk factors of CKD. Results: Age of onset of CKD in 48% of cases was <40 years. Much higher percentage of cases gave family history of CKD (10%), history of consumption of NSAIDs (20%) and smoking for >5 years (30%) as compared to controls. Much more cases as compared to controls gave history of mixed diet (46% vs 26%). Much higher proportion of cases had history of heat exposure, excessive heating and sugarcane exposure (72%, 70% and 48% respectively) as compared to controls. Conclusions: This study supports the association of sugarcane exposure, heat exposure and excessive sweating with CKD and reports a changing trend of renal involvement starting at an earlier age. It highlights need of study with sufficient sample size and greater emphasis on family history, smoking, extent of heat exposure and sugarcane exposure to help identifying area of further research and guide policy making.

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Clinical and Pathological Characterization of Mesoamerican Nephropathy: A New Kidney Disease in Central America

Cited by 167 publications

References 30 publications

Severity and Frequency of Proximal Tubule Injury Determines Renal Prognosis

Severity and Frequency of Proximal Tubule Injury Determines Renal Prognosis

Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy

A study of chronic kidney disease patients with no known risk factors coming to tertiary care hospital

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