Prevalence of and risk factors for chronic kidney disease in rural Nicaragua

O’Donnell, Julie; Tobey, Matthew; Weiner, Daniel E.; Stevens, Lesley A.; Johnson, Sture A. M.; Stringham, Peter; Cohen, Bruce; Brooks, Daniel R.

doi:10.1093/ndt/gfq385

Cited by 122 publications

(150 citation statements)

References 19 publications

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“…Higher BMI and heat stress were negatively associated with CKDu in one third of the studies that reported them ( Figure 2C). Among high-risk populations from this region, the prevalence of CKDu in high-quality studies was reported to be 25.9% and 13.0% in Nicaragua (30,31) and 18.0% in El Salvador (32). In nonendemic countries (four of which were the highincome countries of the United States, Sweden, Japan, and Australia), BMI (n=2) and heavy metals (n=2) were studied most frequently as potential exposures related to CKDu.…”

Section: Resultsmentioning

confidence: 99%

CKD of Uncertain Etiology

Lunyera¹,

Mohottige²,

Isenburg

et al. 2016

Clinical Journal of the American Society of Nephrology

166

148

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Background and objectives Epidemics of CKD of uncertain etiology (CKDu) are emerging around the world. Highlighting common risk factors for CKD of uncertain etiology across various regions and populations may be important for health policy and public health responses.Design, setting, participants, & measurements We searched PubMed, Embase, Scopus and Web of Science databases to identify published studies on CKDu. The search was generated in January of 2015; no language or date limits were used. We used a vote-counting method to evaluate exposures across all studies.Results We identified 1607 articles, of which 26 met inclusion criteria. Eighteen (69%) were conducted in known CKDu-endemic countries: Sri Lanka (38%), Nicaragua (19%), and El Salvador (12%). The other studies were from India, Japan, Australia, Mexico, Sweden, Tunisia, Tanzania, and the United States. Heavy metals, heat stress, and dietary exposures were reported across all geographic regions. In south Asia, family history, agrochemical use, and heavy metal exposures were reported most frequently, whereas altitude and temperature were reported only in studies from Central America. Across all regions, CKDu was most frequently associated with a family history of CKDu, agricultural occupation, men, middle age, snake bite, and heavy metal exposure.Conclusions Studies examining etiologies of CKDu have reported many exposures that are heterogeneous and vary by region. To identify etiologies of CKDu, designing consistent and comparative multisite studies across highrisk populations may help elucidate the importance of region-specific versus global risk factors.

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Section: Resultsmentioning

confidence: 99%

CKD of Uncertain Etiology

Lunyera¹,

Mohottige²,

Isenburg

et al. 2016

Clinical Journal of the American Society of Nephrology

166

148

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“…during his medical residency, when excessive numbers of individuals were presenting at Hospital Rosales in San Salvador with ESRD (35). The disease typically presents in male sugarcane workers from the Pacific coast of Central America, but has since been reported with less frequency in other occupations, including in construction workers, corn and rice farmers, cotton plantation workers, and miners (32,(36)(37)(38). In the affected areas women also have an increased prevalence of CKD, although to a much lesser extent, and there is some preliminary evidence that children from these regions may also be at risk (36,39,40).…”

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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“…Briefly, the study includes two cane cutting groups working in relatively distinct climates -inland (~450 m altitude, cooler climate) and coastland (sea level, hotter climate) -chosen because other studies have demonstrated higher prevalence of kidney dysfunction in hotter environments at sea level (8,27,28). Both groups participated in a previous project (8) and the workers and their leaders were willing to participate again.…”

Section: Study Populationmentioning

confidence: 99%

Intervention to diminish dehydration and kidney damage among sugarcane workers

Wegman¹,

Apelqvist²,

Bottai³

et al. 2017

Scand J Work Environ Health

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Strenuous work in hot environments is associated with negative impacts on biomarkers of kidney function over the workday and over five months. Appropriate access to water, rest and shade during work offers relief from high levels of heat stress and reduces effects on kidney function.Affiliation: University of Massachusetts Lowell, 7 Camden Place, Cambridge, MA 02138, USA. david_wegman@uml.eduThe following article refers to this text: 2018;44(1):1-2

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Prevalence of and risk factors for chronic kidney disease in rural Nicaragua

Abstract: Kidney disease appears common in residents of Quezalguaque, Nicaragua, particularly in younger men, with features most consistent with tubulointerstitial disease. Further research is needed to elucidate the causes of kidney disease in this region.

Cited by 122 publications

References 19 publications

CKD of Uncertain Etiology

CKD of Uncertain Etiology

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

Intervention to diminish dehydration and kidney damage among sugarcane workers

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