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Decreased Kidney Function of Unknown Cause in Nicaragua: A Community-Based Survey

Torres, Cecilia; Aragon, Aurora; Gonzalez, Marvin; Lopez, Indiana; Jakobsson, Kristina LU ; Elinder, Carl-Gustaf; Lundberg, Ingvar and Wesseling, Catharina (2010) In American Journal of Kidney Diseases 55(3). p.485-496
Abstract
Background: End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua. Study Design: Cross-sectional survey. Setting & Participants: Total populations aged 20-60 years of 5 villages in Northwest Nicaragua: mining/subsistence farming (elevation, 100-300 m above sea level), banana/sugarcane (100-300 m), fishing (0-100 m), services (0-100 m), and coffee (200-675 m); 479 men and 617 women (83% response). Predictor or Factor: Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors. Outcomes: Serum creatinine (SCr) values greater than laboratory reference range for sex,... (More)
Background: End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua. Study Design: Cross-sectional survey. Setting & Participants: Total populations aged 20-60 years of 5 villages in Northwest Nicaragua: mining/subsistence farming (elevation, 100-300 m above sea level), banana/sugarcane (100-300 m), fishing (0-100 m), services (0-100 m), and coffee (200-675 m); 479 men and 617 women (83% response). Predictor or Factor: Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors. Outcomes: Serum creatinine (SCr) values greater than laboratory reference range for sex, estimated glomerular filtration rate <60 mL/min/1.73 m(2), proteinuria stratified in the low (dipstick protein excretion, 30-300 mg/dL) and high (>300 mg/dL) range. Results: Prevalences of abnormal SCr levels: 18% (of all men) and 5% (of all women); in the mining/subsistence farming village, 26% and 7%; banana/sugarcane, 22% and 6%; fishing, 13% and 4%; services, 0% and 1%; and coffee, 7% and 0%. Prevalences of estimated glomerular filtration rate <60 mL/min/1.73 m2: 14% (of all men) and 3% (of all women); in the listed villages, 19% and 5%, 17% and 4%, 10% and 2%, 0% and 0%, and 7% and 0%, respectively. Proteinuria, predominantly in the low range, affected 14% and 11% of all men and women without marked differences between villages. By occupation, abnormal SCr levels occurred in 31% and 24% of male and female agricultural workers at 100-300 m above sea level, but not at higher altitudes, and also was high in male artisans (43%), construction workers (15%), and miners (14%). In logistic regression models, for the banana/sugarcane and mining/subsistence farming villages, high blood pressure and age were significant predictors of abnormal SCr levels in men, and for mining/subsistence farming, age in women. Limitations: Causality is not addressed. Conclusions: In some Nicaraguan villages and population segments, men in particular show a high prevalence of decreased kidney function of unknown origin, possibly environmental or occupational. Am J Kidney Dis 55: 485-496. (C) 2010 by the National Kidney Foundation, Inc. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
agriculture, occupation, Central America, prevalence, rate (GFR), glomerular filtration, Serum creatinine, chronic kidney disease (CKD)
in
American Journal of Kidney Diseases
volume
55
issue
3
pages
485 - 496
publisher
Elsevier
external identifiers
  • wos:000275109000013
  • scopus:77049094625
ISSN
1523-6838
DOI
10.1053/j.ajkd.2009.12.012
language
English
LU publication?
yes
id
88f3e82a-68a6-4148-b088-ea008f51a9d3 (old id 1589817)
date added to LUP
2010-04-19 14:19:19
date last changed
2018-05-29 11:08:09
@article{88f3e82a-68a6-4148-b088-ea008f51a9d3,
  abstract     = {Background: End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua. Study Design: Cross-sectional survey. Setting &amp; Participants: Total populations aged 20-60 years of 5 villages in Northwest Nicaragua: mining/subsistence farming (elevation, 100-300 m above sea level), banana/sugarcane (100-300 m), fishing (0-100 m), services (0-100 m), and coffee (200-675 m); 479 men and 617 women (83% response). Predictor or Factor: Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors. Outcomes: Serum creatinine (SCr) values greater than laboratory reference range for sex, estimated glomerular filtration rate &lt;60 mL/min/1.73 m(2), proteinuria stratified in the low (dipstick protein excretion, 30-300 mg/dL) and high (&gt;300 mg/dL) range. Results: Prevalences of abnormal SCr levels: 18% (of all men) and 5% (of all women); in the mining/subsistence farming village, 26% and 7%; banana/sugarcane, 22% and 6%; fishing, 13% and 4%; services, 0% and 1%; and coffee, 7% and 0%. Prevalences of estimated glomerular filtration rate &lt;60 mL/min/1.73 m2: 14% (of all men) and 3% (of all women); in the listed villages, 19% and 5%, 17% and 4%, 10% and 2%, 0% and 0%, and 7% and 0%, respectively. Proteinuria, predominantly in the low range, affected 14% and 11% of all men and women without marked differences between villages. By occupation, abnormal SCr levels occurred in 31% and 24% of male and female agricultural workers at 100-300 m above sea level, but not at higher altitudes, and also was high in male artisans (43%), construction workers (15%), and miners (14%). In logistic regression models, for the banana/sugarcane and mining/subsistence farming villages, high blood pressure and age were significant predictors of abnormal SCr levels in men, and for mining/subsistence farming, age in women. Limitations: Causality is not addressed. Conclusions: In some Nicaraguan villages and population segments, men in particular show a high prevalence of decreased kidney function of unknown origin, possibly environmental or occupational. Am J Kidney Dis 55: 485-496. (C) 2010 by the National Kidney Foundation, Inc.},
  author       = {Torres, Cecilia and Aragon, Aurora and Gonzalez, Marvin and Lopez, Indiana and Jakobsson, Kristina and Elinder, Carl-Gustaf and Lundberg, Ingvar and Wesseling, Catharina},
  issn         = {1523-6838},
  keyword      = {agriculture,occupation,Central America,prevalence,rate (GFR),glomerular filtration,Serum creatinine,chronic kidney disease (CKD)},
  language     = {eng},
  number       = {3},
  pages        = {485--496},
  publisher    = {Elsevier},
  series       = {American Journal of Kidney Diseases},
  title        = {Decreased Kidney Function of Unknown Cause in Nicaragua: A Community-Based Survey},
  url          = {http://dx.doi.org/10.1053/j.ajkd.2009.12.012},
  volume       = {55},
  year         = {2010},
}