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. 2022 Jul 7;23(1):238.
doi: 10.1186/s12882-022-02861-0.

High prevalence of chronic kidney disease of unknown etiology among workers in the Mesoamerican Nephropathy Occupational Study

Sinead A Keogh  1 , Jessica H Leibler  1 , Caryn M Sennett Decker  1 , Juan Jose Amador Velázquez  1   2 , Emmanuel R Jarquin  3 , Damaris Lopez-Pilarte  1   2 , Ramon Garcia-Trabanino  3   4   5 , Iris S Delgado  1   2 , Zoe E Petropoulos  1 , David J Friedman  6 , Magaly Rosario Amador Sánchez  1   2 , Raul Guevara  3 , Michael D McClean  1 , Daniel R Brooks  2 , Madeleine K Scammell  7
Affiliations

High prevalence of chronic kidney disease of unknown etiology among workers in the Mesoamerican Nephropathy Occupational Study

Sinead A Keogh et al. BMC Nephrol. .

Abstract

Background: Mortality from chronic kidney disease of unknown etiology (CKDu) is extremely high along the Pacific coast of Central America, particularly among sugarcane workers. The Mesoamerican Nephropathy Occupational Study (MANOS) is a prospective cohort study of CKDu among agricultural and non-agricultural workers in El Salvador and Nicaragua. The objective of this manuscript is to describe the MANOS cohort recruitment, baseline data collection, and CKDu prevalence after two rounds.

Methods: Workers with no known diabetes, hypertension, or CKD were recruited from sugarcane, corn, plantain, brickmaking, and road construction industries (n = 569). Investigators administered questionnaires, collected biological samples, and observed workers for three consecutive workdays at the worksite. Serum specimens were analyzed for kidney function parameters, and used to calculate estimated glomerular filtration rate (eGFR). At six months, serum was collected again prior to the work shift. CKD at baseline is defined as eGFR ≤ 60 ml/min/1.73m2 at both timepoints. Age-standardized prevalence was calculated by industry, country, and demographic measures. Kidney function parameters were compared by CKD status.

Results: Prevalence of CKD at baseline was 7.4% (n = 42). Age-standardized prevalence was highest in Salvadoran sugarcane (14.1%), followed by Salvadoran corn (11.6%), and Nicaraguan brickmaking (8.1%). Nicaraguan sugarcane had the lowest prevalence, likely due to kidney function screenings prior to employment.

Conclusion: Despite efforts to enroll participants without CKD, our identification of prevalent CKD among agricultural and non-agricultural workers in the MANOS cohort indicates notable kidney disease in the region, particularly among sugarcane workers.

Keywords: CKD; CKD-EPI; Chronic kidney disease of unknown etiology; Cohort study; KDIGO; Kidney function; Mesoamerican nephropathy; Occupational epidemiology; Prevalence; Workers.

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Conflict of interest statement

All authors declare no competing financial interests.

Figures

Fig. 1
Fig. 1
Infographics of MANOS Round 1 data collection process which were shared with workers.
Fig. 2
Fig. 2
Round 1 data collection process at the work site.
Fig. 3
Fig. 3
Cohort derivation.
See this image and copyright information in PMC

References

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