A population-based study of prevalence and risk factors of chronic kidney disease in León, Nicaragua.
BACKGROUND
Recent studies have shown an excess of chronic kidney disease (CKD) among younger adult males in the Pacific coastal region of Nicaragua and suggest a non-conventional CKD etiology in this region. These studies have been conducted in small, non-representative populations.


OBJECTIVE
We conducted a large population-based cross-sectional study to estimate CKD prevalence in León, Nicaragua, and to evaluate the association between previously investigated risk factors and CKD.


METHODS
Estimated glomerular filtration rate, derived using the MDRD equation, was assessed to determine CKD status of 2275 León residents. Multivariable logistic regression was used to estimate adjusted prevalence odds ratios. León CKD prevalence was also standardized to the demographic distributions of the León Health and Demographic Surveillance System and the León 2005 Census.


RESULTS
CKD prevalence was 9.1%; twice as high for males (13.8%) than females (5.8%). In addition to gender, older age, rural zone, lower education level, and self-reported high blood pressure, more years of agricultural work, lija (unregulated alcohol) consumption, and higher levels of daily water consumption were significantly associated with CKD. Notably, self-reported diabetes was associated with CKD in adjusted models for females but not males.


CONCLUSIONS
Our findings are comparable to those found in regional studies and further support the hypothesis of a Mesoamerican Nephropathy.
UNC Kidney Center, 7024 Burnett-Womack CB # 7155, Chapel Hill, NC 27599-7155 USA.
Jill F
JF
Lebov
Centro de Investigaciones e Intervenciones en Salud, León, Nicaragua.
Eliette
E
Valladares
Centro de Investigaciones e Intervenciones en Salud, León, Nicaragua.
Rodolfo
R
Peña
Centro de Salud Torre Ramona, Unidad Docente de Medicina Familiar y Comunitaria, Sector II, Zaragoza, España.
Edgar M
EM
Peña
Duke University, Durham, NC.
Scott L
SL
Sanoff
Department of Physiological Sciences, UNAN-León, Nicaragua.
Efren Castellón
EC
Cisneros
UNC Kidney Center, 7024 Burnett-Womack CB # 7155, Chapel Hill, NC 27599-7155 USA.
Romulo E
RE
Colindres
Department of Medicine, Vanderbilt University, Nashville, TN USA ; Department of Medicine, UNC Chapel Hill, NC USA.
Douglas R
DR
Morgan
UNC Kidney Center, 7024 Burnett-Womack CB # 7155, Chapel Hill, NC 27599-7155 USA.
Susan L
SL
Hogan
Central America; Chronic kidney disease; Mesoamerican nephropathy; Nicaragua