Kidney Week

Abstract: TH-PO1058

Far from the “Hot Coast”: Prevalence of Mesoamerican Nephropathy (MeN) in a Cooler Mountain Community of Nicaragua

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

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

Authors

• Bianchi, Stefano, ASLNordovest, UOC di Nefrologia e Dialisi, Livorno, Toscana, Italy

Stefano Bianchi,

• Cellai, Filippo, ASLNordovest, UOC di Nefrologia e Dialisi, Livorno, Toscana, Italy

Filippo Cellai,

• Nistri, Francesca, ASLNordovest, UOC di Nefrologia e Dialisi, Livorno, Toscana, Italy

Francesca Nistri,

• Grillo, Andrea, ASLNordovest, UOC di Nefrologia e Dialisi, Livorno, Toscana, Italy

Andrea Grillo,

• Bigazzi, Roberto, ASLNordovest, UOC di Nefrologia e Dialisi, Livorno, Toscana, Italy

Roberto Bigazzi,

Background

MeN is an “epidemic” of chronic kidney disease ( CKD) of unknown etiology , affecting populations of Nicaragua (N) and other pacifical coast regions wich are all caracterized by high temperature. Dehydration, volume depletion and heat stress are all risk factors for MeN commonly linked to strenuous work conditions during seasonal harvest. In a previous study , we have found an high prevalence of MeN (26,4%) in a general population (GP) sample of a costal city (Leon, N). The pecularity of our results has been a census based general population analysis , and not a selected group of subjects as reported in the majority of the previous studies published on this issue , mainly involving sugar cane agricoltural workers .
The aim of the present study was to investigate MeN prevalence in the general population of a city (Condega ,N), which is located at 560 feet above sea level, very far from the pacific coast, with different mean temperatures (daily mean 22C° vs 30 C°of Leon ) and farmer activities (mainly coffee) .

Methods

Out of a GP population of 28.481 inhabitants, we ramdomly selected 1024 subjects aged ≥ 18 years .The final sample of population we have studied counted 976 subjects , mean age 41.84 ± 16.73; 457 males and 519 females. Blood and urine samples were collected to estimate glomerular filtration rate (eGFR-CDK-EPI, mL/min/1.73 m2) and urine albumin excretion (UAE, albumin mg/creatinine g).

Results

Among 976 participants to the study, 725 (74.28%; mean age 39.7; 358 males and 385 females) had normal eGFR; 251 (25.7 %; mean age 46.53; 106 males and 145 females) manifested CKD (14.3 % stage 1, 16.7 % stage 2, 35.1% stage 3a, 12.4% stage 3b, 10.8% stage 4, 10.4% stage 5). Out of 173 participants in stage 3-5 of CKD, 143 ( 82,7%) had UAE<30 mg/g , 23 ( 13,3%) had UAE>30 mg/g <300 mg/g and only 7 ( 4%) had UAE> 300 mg/g

Conclusion

In Nicaragua , even far from the high temperatures of the pacific cost , the prevalence of MeN seems to be very high . The cause(s) of MeN remains still unknown. However, there is more than dehydration, volume depletion and heat stress.

Funding

• Other NIH Support