*WINNER* MesoAmerican Nephropathy: A Growing Problem in Central America

Abstract

Mesoamerican nephropathy is chronic kidney disease (CKD) that is lacks clear etiology and presents primarily in healthy young men living in Central America. In one report from a town in Nicaragua, the prevalence of CKD was 42% among men and 9.8% among women. From 1992-2002 the CKD-related mortality rate increased from 4 to 10 cases per 100,000 Nicaraguan inhabitants. Patients do not have pre-existing factors such as diabetes or hypertension, setting this type of nephropathy apart from what is typically seen. Research suggests nontraditional factors contributing to rapid decline in kidney function include; outdoor and agriculture work, lack of shade during work breaks, exposure to pesticides and live in low altitude homes. A patient with mesoamerican nephropathy may present with arthralgias, muscle cramps, dysuria and flank pain. All of these symptoms lead to the prescription of NSAIDs and antibiotics which are both known to cause damage to the glomerulus when used in excess. Physicians and pharmacists in Nicaragua state that they are aware that this is a growing problem in their area and they know the contributing factors. However, what has not been determined is what present practices do they have in place to educate and prevent mesoamerican nephropathy in young males?