Decreased kidney function of unknown cause in Nicaragua: a community-based survey.
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.


METHODS
Cross-sectional survey.


METHODS
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).


METHODS
Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors.


RESULTS
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 m(2): 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.


CONCLUSIONS
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.
Torres
Cecilia
C
Research Centre on Health, Work and Environment, National Autonomous University of Nicaragua at León, León, Nicaragua. ceciliatorreslacourt@yahoo.com
Aragón
Aurora
A
González
Marvin
M
López
Indiana
I
Jakobsson
Kristina
K
Elinder
Carl-Gustaf
CG
Lundberg
Ingvar
I
Wesseling
Catharina
C
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009527:Nicaragua; D015995:Prevalence; D055815:Young Adult