Kidney Week

Abstract: FR-PO0292

Prevalence and Occupational Determinants of CKD of Uncertain Etiology in Mesoamerica: A Systematic Review and Meta-Analysis

Session Information

• CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Romero Ríos, Christopher Kaleb, Universidad de Defensa de Nicaragua "4 de Mayo", Managua, Nicaragua

Christopher Kaleb Romero Ríos, MS

• Laguna Joa, Yohanny Saraith, Universidad del Zulia, Maracaibo, Zulia, Venezuela, Bolivarian Republic of

Yohanny Saraith Laguna Joa, MD

• Medina Sanchez, Jose Antonio, Universidad del Zulia, Maracaibo, Zulia, Venezuela, Bolivarian Republic of

Jose Antonio Medina Sanchez, MD

• Perozo, Karla, Universidad del Zulia, Maracaibo, Zulia, Venezuela, Bolivarian Republic of

Karla Perozo, MD

• Parikh, Aarohi, HCA Houston Healthcare, Houston, Texas, United States

Aarohi Parikh, MD

• Calderon Martinez, Ernesto, Texas Tech University Health Sciences Center El Paso, El Paso, Texas, United States

Ernesto Calderon Martinez, MD

Background

Mesoamerican Nephropathy (MeN), a chronic kidney disease of unknown cause, disproportionately affects agricultural communities in Mesoamerica. This study synthesizes prevalence estimates, renal parameters, and epidemiological risk factors for MeN.

Methods

In this PRISMA-compliant PROSPERO-registered (CRD420251159842) systematic review and meta-analysis, eight databases were searched through October 2025 for observational studies of adult renal outcomes in Mesoamerica. Pooled prevalence, means, and odds ratios were estimated using random-effects and multilevel models. Heterogeneity and certainty were assessed via meta-regression, GOSH plots, E-values, and GRADE.

Results

30 studies with 18,504 participants were included. Pooled prevalence of eGFR < 60 mL/min/1.73 m2 was 4.9% (95% CI: 3.4%–7.0%), higher in community cohorts (6.5%) than active sugarcane workers (3.4%), reflecting a healthy worker survivor effect. Multilevel modeling showed no difference between high-intensity field workers and low-to-moderate intensity support staff (p=0.79). Mean eGFR (108.22 mL/min/1.73 m2) and creatinine (0.95 mg/dL) were nominally normal but below expected values for these young, predominantly male populations. Significant risk factors included agricultural work (OR = 2.24; 95% CI: 1.05–4.76), agrochemical exposure (OR = 2.10; 95% CI: 1.41–3.14), and sugarcane harvesting (OR = 1.88; 95% CI: 1.28 2.77); diabetes was not significant. Altitude was protective (p = 0.005). Evidence certainty: low to very low.

Conclusion

MeN is an occupational and environmental epidemic driven by agricultural labor, agrochemical exposure, and low-altitude climates, distinct from traditional cardiometabolic disease. Targeted interventions, including mandated hydration protocols and enhanced agrochemical regulation, are urgently needed.

Acknowledgment

We acknowledge Lorenzo Eugenio Aragon Conrado for his assistance with the initial title and abstract screening of the literature.