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ISSN 1527-3172 (Electronic)

2014, Number 2

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MEDICC Review 2014; 16 (2)

Chronic Kidney Disease of Unknown Etiology in Agricultural Communities

Almaguer, M, Herrera R, Orantes CM

Language: Spanish
References: 49
Page: 9-15
PDF size: 252.34 Kb.


ABSTRACT

In recent years, Central America, Egypt, India and Sri Lanka have reported a high prevalence of chronic kidney disease of unknown etiology in agricultural communities, predominantly among male farmworkers. This essay examines the disease’s case defi nitions, epidemiology (disease burden, demographics, associated risk factors) and causal hypotheses, by reviewing published fi ndings from El Salvador, Nicaragua, Costa Rica, Sri Lanka, Egypt and India. The range of confi rmed chronic kidney disease prevalencew as 17.9%–21.1%. Prevalence of reduced glomerular filtration (‹ 60 mL/min/1.73m2 body surface area) based on a single serum creatinine measurement was 0%–67% men and 0%–57% women. Prevalence was generally higher in male farmworkers aged 20–50 years, and varied by community economic activity and altitude. Cause was unknown in 57.4%–66.7% of patients. The dominant histopathological diagnosis was chronic tubulointerstitial nephritis. Associations were reported with agricultural work, agrochemical exposure, dehydration, hypertension, homemade alcohol use and family history of chronic kidney disease. There is no strong evidence for a single cause, and multiple environmental, occupational and social factors are probably involved. Furthere tiological research is needed, plus interventions to reduce preventable risk factors.


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