title: Leptospira seropositivity as a risk factor for Mesoamerican Nephropathy.
abstract: Leptospirosis is postulated as a possible cause of Mesoamerican Nephropathy (MeN) in Central American workers.
  
  
  
  Investigate job-specific Leptospira seroprevalence and its association with kidney disease biomarkers.
  
  
  
  In 282 sugarcane workers, 47 sugarcane applicants and 160 workers in other industries, we measured anti-leptospiral antibodies, serum creatinine, and urinary injury biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and N-acetyl-D-glucosaminidase (NAG).
  
  
  
  Leptospira seroprevalence differed among job categories and was highest among sugarcane cutters (59%). Seropositive sugarcane workers had higher NGAL concentrations (relative mean: 1.28; 95% CI: 0.94-1.75) compared to those who were seronegative, with similar findings among field and non-field workers.
  
  
  
  Leptospira seroprevalence varied by job category. There was some indication that seropositivity was associated with elevated biomarker levels, but results were inconsistent. Additional studies may help establish whether Leptospira infection plays any role in MeN among Central American workers.
authors.affiliation: a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.
authors.forename: Alejandro
authors.identifier: 0000-0002-1948-9219
authors.initials: A
authors.lastname: Riefkohl
authors.affiliation: a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.|b Preventive Medicine and Public Health Department , Universidad Autónoma de Madrid , Madrid , Spain.
authors.forename: Oriana
authors.initials: O
authors.lastname: Ramírez-Rubio
authors.affiliation: c Department of Environmental Health , Boston University School of Public Health , Boston , MA , USA.
authors.forename: Rebecca L
authors.identifier: 0000-0001-8249-5999
authors.initials: RL
authors.lastname: Laws
authors.affiliation: c Department of Environmental Health , Boston University School of Public Health , Boston , MA , USA.
authors.forename: Michael D
authors.initials: MD
authors.lastname: McClean
authors.affiliation: d Division of Nephrology, Department of Medicine , Tufts Medical Center and Tufts University School of Medicine , Boston , MA , USA.
authors.forename: Daniel E
authors.identifier: 0000-0002-8775-394X
authors.initials: DE
authors.lastname: Weiner
authors.affiliation: e Research Service, VA New York Harbor Healthcare System and New York University School of Medicine , New York , NY , USA.
authors.forename: James S
authors.identifier: 0000-0002-6778-4167
authors.initials: JS
authors.lastname: Kaufman
authors.affiliation: f Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens & Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Renee L
authors.initials: RL
authors.lastname: Galloway
authors.affiliation: f Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens & Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Sean V
authors.identifier: 0000-0001-7446-5263
authors.initials: SV
authors.lastname: Shadomy
authors.affiliation: f Bacterial Special Pathogens Branch, Division of High-Consequence Pathogens & Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta , GA , USA.
authors.forename: Marta
authors.initials: M
authors.lastname: Guerra
authors.affiliation: a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Amador
authors.affiliation: a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.
authors.forename: José Marcel
authors.initials: JM
authors.lastname: Sánchez
authors.affiliation: a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.
authors.forename: Damaris
authors.initials: D
authors.lastname: López-Pilarte
authors.affiliation: g Section of Nephrology, Department of Medicine , Yale University , New Haven , CT , USA.|h Program of Applied Translational Research, Department of Medicine , Yale University , New Haven , CT , USA.
authors.forename: Chirag R
authors.initials: CR
authors.lastname: Parikh
authors.affiliation: c Department of Environmental Health , Boston University School of Public Health , Boston , MA , USA.
authors.forename: Jessica H
authors.initials: JH
authors.lastname: Leibler
authors.affiliation: a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Brooks
mesh_terms: D000328:Adult; D000907:Antibodies, Bacterial / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D000067565:Farmers / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D020382:Interleukin-18 / Q000097:blood; D007919:Leptospira / Q000276:immunology*; D007922:Leptospirosis / Q000097:blood / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D000071068:Lipocalin-2 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009527:Nicaragua / Q000453:epidemiology; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D015415:Biomarkers; D020382:Interleukin-18; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D003404:Creatinine
keywords: Chronic kidney disease (CKD); Chronic kidney disease of nontraditional etiology (CKDnt); Ieptospirosis; Interleukin-18 (IL-18); Leptospira; Mesoamerican Nephropathy (MeN); N-acetyl-D- glucosaminidase (NAG); Neutrophil gelatinase-associated lipocalin (NGAL)