Clinical characteristics of chronic kidney disease of non-traditional causes in women of agricultural communities in El Salvador.
BACKGROUND
A chronic kidney disease of non-traditional causes (CKDu) has emerged in Central America and elsewhere, predominantly affecting male farmworkers. In El Salvador (2009), it was the second cause of death in men > 18 years old. Causality has not been determined. Most available research focused on men and there is scarce data on women.


OBJECTIVE
Describe the clinical and histopathologic characteristics of CKDu in women of agricultural communities in El Salvador.


METHODS
A descriptive study was carried out in 10 women with CKDu stages 2, 3a, and 3b. Researchers studied demographics, clinical examination; hematological and biochemical analyses, urine sediment, renal injury markers, and assessed renal, cardiac, and peripheral arteries, liver, pancreas, and lung anatomy and functions. Kidney biopsy was performed in all. Data was collected on the Lime Survey platform and exported to SPSS 19.0.


RESULTS
Patient distribution by stages: 2 (70%), 3a (10%), 3b (20%). Occupation: agricultural 7; non-agricultural 3.


METHODS
agrochemical exposure 100%; farmworkers 70%; incidental malaria 50%, NSAIDs use 40%; hypertension 40%.


METHODS
nocturia 50%; dysuria 50%; arthralgia 70%; asthenia 50%; cramps 30%, profuse sweating 20%. Renal markers: albumin creatinine ratio (ACR) > 300 mg/g 90%; β microglobulin and neutrophil gelatinase- associated lipocalin (NGAL) presence in 40%. Kidney function: hypermagnesuria 100%; hyperphosphaturia 50%, hypercalciuria 40%; hypernatriuria 30%; hyponatremia 60%, hypocalcemia 50%. Doppler: tibial artery damage 40%. Neurological: reflex abnormalities 30%; Babinski and myoclonus 20%. Neurosensorial hypoacusis 70%. Histopathology: damage restricted mostly to the tubulo-interstitium, urine was essentially bland.


CONCLUSIONS
CKDu in women is a chronic tubulointerstitial nephropathy with varied extrarenal symptoms.
Nephrology Institute, Havana, Cuba, National Health Institute, Ministry of Health, San Juan de Dios National Hospital, San Miguel, El Salvador, Renal Physiopathology Department, Physiopathology Department, Nephrology Institute, National School of Public Health, Havana, Cuba, and Renal Health Research Unit (RHRU), National Health Institute Health, Ministry of Health, San Salvador, El Salvador.
Raúl
R
Herrera Valdés
Carlos M
CM
Orantes
Miguel
M
Almaguer López
Laura
L
López Marín
Pedro Alfonso
PA
Arévalo
Magaly J
MJ
Smith González
Fabrizio E
FE
Morales
Raymed
R
Bacallao
Héctor D
HD
Bayarre
Xavier F
XF
Vela Parada
D000328:Adult; D000383:Agriculture; D016573:Agrochemicals / Q000009:adverse effects*; D004544:El Salvador / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000139:chemically induced / Q000453:epidemiology*; D012307:Risk Factors
D016573:Agrochemicals