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Abstract: TH-PO1059

eGFR, CKD Epidemiology in a Nicaraguan High Risk Area for Mesoamerican Nephropathy (MeN)

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Sidoti, Antonino, Nephrology Unit Poggibonsi (Si) Italy, Pisa, Italy
  • Vargas, Martha, Fundacion Coen, Chinandega, Nicaragua
  • Sequeira Reyes, Maria José, Fundacion Coen, Chinandega, Nicaragua
  • Mazzacani, Paolo, Fundacion Coen, Chinandega, Nicaragua

Group or Team Name

  • Consulta Nefrologica, Fundación Coen, Chinandega, Nicaragua
Background

MeN is linked with field working at sea level (mainly sugarcane) CKD and death in young age. Chinandega department has the two biggest sugarcane country plantations in El Viejo and Chichigalpa, CKD prevalence figures and etiology are unknown. On 2017 we enrolled age 12-22 people for a three years study to detect CKD precociously, assess CKD prevalence and risk factors, facilitate nephrological medical consult.

Methods

Population is 51746, by double randomization sampling 1202 record were completed. Plasma creatinine, blood pressure (BP), weight, height were measured; a questionnaire on occupation, water source, medical history, use of nSAID was administered. eGFR<60ml/min’ was diagnostic for CKD with Schwartz bedside for children and CKD-EPI for adults (Schw_CKD_EPI). eGFR via combined full age spectrum formula (FAS) for children and CKD-EPI for adults (FAS_CKD_EPI) was calculated to choose the best suited formula for longitudinal eGFR follow-up and to compare different communities (Pearson bivariate). Schw_CKD_EPI eGFR was used for continuous and quartiles variable analyses by Anova and χ squared testing respectively. CI by Jeffreys method.

Results

Schw_CKD_EPI was 101±21, CKD-EPI 121±14, FAS_CKD_EPI 118±18. Schwartz vs FAS r=-790, p<.001. CKD prevalence was 0.75% (CI 0.31-1.36). Three municipalities had cases: Corinto 0,67% (CI 0.12-3.6),Chichigalpa 0.78%(CI 0.22-2.8), El Viejo 0.73% (CI 0.28-1.5). There was no relationship between eGFR and previous and actual occupation, medical antecedent i.e.dengue n=133, leptospirosis n=6, recurrent urinary tract infections n=209, previous episodes of dehydration n=119, frequent tonsillitis n=542, chikungunya n=293, malaria n=36, water source, fluid intake, frequent use of nSAID n=408, BP. Three communities (LM, KI, MA) were at extremes for eGFR. Differences in eGFR were better discriminated (p<.05) with FAS_CKD_EPI than Schw_CKD_EPI (pNS): LM 127±20 vs 88±18, KI 110±19vs 105±18, MA 129±12 vs. 93±17 respectively.

Conclusion

CKD prevalence is very high, well above NHANES 2011-14 age 20-39 (0.3%). No clues about causality come from our baseline data. In the subsequent years of study FAS_CKD_EPI use is advisable to focus geographical areas of investigation and health interventions, moreover its closeness with CKD-EPI values would help eGFR follow up from pediatric to adult age.

Funding

  • Private Foundation Support