Kidney Week

Abstract: FR-PO496

Decreased Kidney Function Among a Rural Population in Veracruz, Mexico: A Cross-Sectional Study

Session Information

• CKD: Epidemiology, Outcomes - Non-Cardiovascular - I
  November 03, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 304 CKD: Epidemiology, Outcomes - Non-Cardiovascular

Authors

• Madero, Magdalena, National Heart Institute, Division of Nephrology, Mexico, Mexico

Magdalena Madero,

• Aguilar, Diego J, Universidad Panamericana School of Medicine, Mexico, D.F., Mexico

Diego J Aguilar,

• Raña, Alejandro, Universidad Panamericana School of Medicine, Mexico, D.F., Mexico

Alejandro Raña,

• Escobar, Alejandro, National Heart Institute, Division of Nephrology, Mexico, Mexico

Alejandro Escobar,

• Villa, Antonio, Universidad Panamericana School of Medicine, Mexico, D.F., Mexico

Antonio Villa,

• Obrador, Gregorio T., Universidad Panamericana School of Medicine, Mexico, D.F., Mexico

Gregorio T. Obrador,

Background

An epidemic of CKD of unknown origin (CKDu) has emerged in Central America, particularly in young male sugarcane workers. CKDu cases have been reported from Tierra Blanca, Veracruz, a region with similar environmental and socioeconomic characteristics to those described in Central America. To date, there are no epidemiologic reports of CKD hotspots in Mexico.

Methods

A cross-sectional study included adults with or without risk factors for CKD aged 20-60 from 3 communities in Tierra Blanca, Mexico. Sociodemographic, clinical, occupational and environmental data were collected from 613 participants. Standardized serum creatinine and albumin-creatinine ratio were measured; glomerular filtration rate (eGFR) was estimated using CKD-EPI equation. Patients were categorized with or without CKD according to KDIGO classification. Factors associated with lower eGFR were assessed using a multiple logistic regression model.

Results

Mean age was 41(±11), and 200(32.6%) were men. Prevalence of CKD (G1-G5) was 24.9%, mostly driven by albuminuria (Figure 1), and was similar between male and female participants. Presence of DM or HTN was more frequent in the group with CKD (33.9% and 33.9%); nevertheless, 68 (44.4%) of the participants identified with probable CKD did not have a traditional risk factor. Independent factors associated with an eGFR <90 mL/min/1.73 m² were older age(OR=1.07[1.04 - 1.10]), DM(OR=1.7[.99 - 3.19]), family history of CKD(OR=2.03[1.1 – 3.5]) and history of sugarcane work(OR=2.2 [1.1-4.3]).

Conclusion

This is the first epidemiologic report of a possible CKDu hotspot in Mexico. A high prevalence of CKD in these communities was found. Moreover, almost half of the cases could be classified as uCKD. Non-traditional risk factors, such as the history of sugarcane work, were associated with lower eGFR. The cross-sectional nature of the study prevents etiologic interpretations; a longitudinal assessment to further characterize this possible CKD hotspot is being planned.

Funding

• Private Foundation Support