Abstract: PUB002
The Intersection of Health and Climate Change: A Case of Meso- American Nephropathy (MeN) in NJ
Session Information
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Saleem, Bushra Z., Capital Health, Trenton, New Jersey, United States
- Merchant, Khadija, Capital Health, Trenton, New Jersey, United States
- Ali, Doaa, Capital Health, Trenton, New Jersey, United States
- Nawreen, Nazia, Capital Health, Trenton, New Jersey, United States
- Kazmi, Raza A, Capital Health, Trenton, New Jersey, United States
- Patel, Hesha, Capital Health, Trenton, New Jersey, United States
- Singh, Achint Kaur, Rowan University, Glassboro, New Jersey, United States
Background
MeN, also known as CKD of unknown origin, has emerged as an epidemic in Central America but has also been reported globally. Mostly effecting young, otherwise healthy men with no traditional risk factors of CKD, etiology is believed to be heat stress. Strenuous work under extreme heat can cause repeated episodes of dehydration leading to kidney injury. The osmotic injury due to high fructose containing drinks used for hydration may also contribute in worsenning of disease. MeN may be one of the first major diseases attributed to climate change. Here we present a case series of such patients identified at our institute.
Methods
We conducted a cross sectional study in patients who presented with kidney disease from June 2022 to June 2023 at Capital Health. We screened 921 patients between 18-55 years of age. Patients with traditional risk factors of kidney disease were excluded. Cases were identified by manual chart review and a case series detailing sociodemographic characteristics, co-morbidities, presenting symptoms and clinical course was prepared.
Results
15 male patients were identified who met the criteria of MeN, kidney disease due to repeated dehydration, at risk occupation, with no other identified etiology. Average age was between 20-45 years. 3 of them were landscaper, 3 roofers, 4 construction worker, 2 athlete, 1 farmer, 1 factory worker & 1 delivery person. All 15 patients presented with elevated creatinine (1.5 – 7mg/dl). Presenting synptoms were nausea, vomiting, headache, diffuse body ache & muscle cramps. 1 patient underwent kidney biopsy showing tubulo-interstitial fibrosis and glomerular hypertrophy but no GBM disease. 13/15 patients recovered with IV fluids. At least 2/15 patient progressed to CKD. 1/15 patient progressed to ESRD requiring Hemodialysis.
Conclusion
MeN is emerging as a public health problem. Currently the magnitude of disease burden caused by MeN in our region is unknown. However, it is evident, if not identified at an earlier stage this can lead to CKD and ESRD. There is an urgent need for further research in this realm. It is germane to identify population at risk, develop preventative and interventional strategies. Preventive measures such as avoidance of heat, consistent hydration, clean water source and use of heat protective mechanisms, has demonstrated good outcomes.