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Abstract: FR-PO178

Association of Hyperuricemia to Mesoamerican Nephropathy

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Garcia-Trabanino, Ramon, Centro de Hemodialisis, San Salvador, El Salvador
  • Romero alejo, Joel Ernesto, Instituto Salvadoreño del Seguro Social, Jiquilisco, Usulutan, El Salvador
  • Rodriguez, Maria V., Universidad de El Salvador, San Salvador, El Salvador
  • Jarquin, Emmanuel, AGDYSA , San Salvador, El Salvador
  • Vindell, Juan José, Universidad de El Salvador, San Salvador, El Salvador
Background

Mesoamerican nephropathy (MeN) is considered a new entity among chronic kidney diseases (CKD), but still of uncertain etiology (CKDu). Some risk factors and characteristics identified through previous cross-sectional studies are: agriculture work -mainly sugar cane work-, hot environment, hyperuricemia and dysuria. The aim of our study was to reassess the role of hyperuricemia in adult subjects with altered kidney function (AKF) and without diabetes mellitus (DM) and hypertension (HTN), traditional risk factors of CKD.

Methods

The studied sample came from 10 communities in a known hotspot of MeN in El Salvador (Bajo Lempa region). We used a cross sectional design where incoming participants were grouped depending on different exposures: Group 1: previous diagnose of DM and/or HTN, and agriculture work; group 2: DM/HTN without agriculture; group 3: agriculture without DM/HTN, and group 4: non-DM/HTN without agriculture. They were included independent of previous diagnosis of CKD or hyperuricemia. Our primary outcomes were: AKF, defined by elevated serum creatinine (SCr) or eGFR <60 mL/min/1.72m2 (MDRD equation), and hyperuricemia, defined by elevated serum uric acid (male: >7 mg/dL, female: >6 mg/dL) or daily intake of allopurinol prescribed by a physician.

Results

681 subjects were included: 58.4% female, mean age 42 years (SD + 17.291) with the following distribution: group 1: 14 subjects, group 2: 20 subjects, group 3: 282 subjects, and group 4: 365 subjects. Frequency of AKF for each corresponding group: 78.5%, 45%, 23.40%, and 18.63%, p=0.000. The frequency of hyperuricemia in subjects without AKF was 15.68%, and with AKF 43.27%, p=0.000. Comparing all subjects with AKF and hyperuricemia we found that working in agriculture presented higher frequency (62.2%, p=0.006). Comparing those in groups 2 and 3 with AKF for hyperuricemia we found a frequency of 44.44% and 54.44%, respectively. With a multivariate analysis, DM, HTA, dysuria, and hyperuricemia were statistically associated to AKF (p<0.0001) but not agriculture work (p=0.094) or ever working in sugar cane culture (p=0.252).

Conclusion

More research with stronger design is needed to study this factor as it might seem that uric acid has a role in AKF in this region, mostly in those without traditional risk factors (CKDu).