Decreased kidney function and agricultural work: a cross-sectional study in middle-aged adults from Tierra Blanca, Mexico

Aguilar‐Ramirez, Diego; Raña-Custodio, Alejandro; Villa, Antonio; Rubilar, Ximena; Olvera, Nadia; Escobar, Alejandro; Johnson, Richard J.; Sánchez‐Lozada, Laura G.; Obrador, Gregorio T.; Madero, Magdalena

doi:10.1093/ndt/gfaa041

Cited by 18 publications

(18 citation statements)

References 20 publications

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“…Interestingly, the frequency of undetected hypertension was higher in this group compared with those with grade 3 to grade 5 disease (35.6% vs. 13.8%, P < .01). Our finding is similar to the report by Aguilar-Ramirez et al 16 among adults from an agricultural community in Tierra Blanca, Mexico. They diagnosed CKD on the basis of A3 or higher proteinuria alone in about 24% of subjects with grade 1 to grade 2 disease.…”

Section: Discussionsupporting

confidence: 92%

A Systematic Study of the Prevalence and Risk Factors of CKD in Uddanam, India

Gummidi

John

Ghosh

et al. 2020

Kidney International Reports

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Introduction Despite reports of a high prevalence of chronic kidney disease (CKD) from the coastal Uddanam region of Andhra Pradesh, India, there are no accurate data on the distribution of kidney function abnormalities and CKD risk factors in this region. Methods A total of 2419 participants were recruited through multistage cluster random sampling from 67 villages. Serum creatinine and urine protein creatinine ratio were measured using validated methodologies. All abnormal estimated glomerular filtration rate (eGFR) and urine protein creatinine ratio values were reconfirmed after 3 months. A range of sociodemographic factors were evaluated for their association with CKD using Poisson regression. Results Of 2402 eligible subjects (mean ± SD age, 45.67 ± 13.29 years; 51% female), 506 (21.07%) had CKD (mean ± SD age, 51.79 ± 13.12 years; 41.3% female). A total of 246 (10.24%) had eGFR <60 ml/min/1.73 m 2 , whereas 371 (15.45%) had an elevated urine protein creatinine ratio (>0.15 g/g). The poststratified estimates, adjusted for age and sex distribution of the region for CKD prevalence, are 18.7% (range, 16.4%–21.0%) overall and 21.3% (range, 18.2%–24.4% ) and 16.2% (range, 13.7%–18.8%) in men and women, respectively. Older age, male sex, tobacco use, hypertension, and family history of CKD were independently associated with CKD. Compared with those with higher eGFR, those with eGFR <60 ml/min/1.73m 2 were older, were more likely to be uneducated, manual laborers/farmers, or tobacco users, and were more likely to have hypertension, a family history of CKD, a diagnosis of heart disease, and a lower body mass index. Among those with low eGFR, there was no difference between those with urine protein creatinine ratio <0.15 or >0.15, except a lower frequency of males in the former. Conclusion We confirmed the high prevalence of CKD in the adult population of Uddanam. The cause was not apparent in a majority. Subjects with a low eGFR with or without elevated proteinuria were phenotypically distinct from those with proteinuria and preserved eGFR. Our data suggest the need to apply a population-based approach to screening and prevention and studies to understand the causes of CKD in this region.

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Section: Discussionsupporting

confidence: 92%

A Systematic Study of the Prevalence and Risk Factors of CKD in Uddanam, India

Gummidi

John

Ghosh

et al. 2020

Kidney International Reports

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“…In general, despite several hypotheses being considered, the risk factors, pathophysiological mechanisms, diagnostic methods and treatment of CKDu are not explicitly established. 104 Hence, there is a need for well-designed, more conclusive studies examining causation, clear pathogenesis, and validation of more sensitive biomarkers to unravel the mystery of this disease.…”

Section: Future Directionsmentioning

confidence: 99%

<p>Purposeful Review to Identify Risk Factors, Epidemiology, Clinical Features, Treatment and Prevention of Chronic Kidney Disease of Unknown Etiology</p>

Abdissa¹

2020

IJNRD

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The global burden of chronic kidney disease (CKD) has risen, and chronic kidney disease of unknown etiology (CKDu) contributes considerably to the national burden of CKD. It is characterized by irreversible, slowly advancing disease, and symptoms often appear in the late stages of the disease. It is a serious, novel cause of kidney failure and leads to premature deaths. Many hypotheses have emerged; however, the etiology of CKDu continues to be elusive and debatable and it is claimed that the etiology is multifactorial, encompassing environmental, genetic, occupational, and social factors. The dominant histopathological feature is chronic tubulointerstitial nephritis. It predominantly affects individuals with low socio-economic status, of working age, largely without chronic comorbidities, who perform strenuous labor in extreme conditions in various tropical areas of the world. It is often fatal due to fast progression and limited access to dialysis or transplant options in the involved geographic areas. Early recognition and appropriate interventions at the earliest possible stage are imperative for decreasing its associated morbidity and mortality. In this review, I tried to summarize available evidence on the risk factors, epidemiology, clinical features, treatment, and prevention of CKDu. The literature search for this review was conducted comprehensively by using different electronic databases and by using appropriate search terms.

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“…More recently, Aguilar-Ramirez et al described another probable hotspot in Veracruz, Mexico, an area that shares the same demographic characteristics and agriculture as the main occupation. 29 Since the first described area, multiple hypotheses with regards to environmental, occupational and hereditary factors have been postulated. 20 Recently, 52 epidemiological studies from sugarcane cutters were evaluated showing they are under physical and mental thermal overload conditions, are more exposed to pollutants and to accidents.…”

Section: Risk Factors and Pathophysiologymentioning

confidence: 99%