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  • Editor in Chief: Prof. Giovanni Gambaro
  • Co-Editor: Benedetta Bussolati
  • Current issue: Vol. 26 issue Suppl. 22 , 2013 (November-December)

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Vol. 25 - Issue 4 (July-August 2012)

Nicaragua revisited: evidence of lower prevalence of chronic kidney disease in a high-altitude, coffee-growing village

Nicaragua revisited: evidence of lower prevalence of chronic kidney disease in a high-altitude, coffee-growing village

J Nephrol 2012; 25(4): 533 - 540

Article Type: ORIGINAL ARTICLE

DOI:10.5301/jn.5000028

Authors

Timothy S. Laux, Philip J. Bert, Gerardo M. Barreto Ruiz, Marvin González, Mark Unruh, Aurora Aragon, Cecilia Torres Lacourt

Abstract

Background: Chronic kidney disease (CKD) is found at epidemic levels in certain populations of the Pacific Coast in northwestern Nicaragua especially in younger men. There are knowledge gaps concerning CKD’s prevalence in regions at higher altitudes. Methods: A cross-sectional study of adults between the ages of 20 and 60 years in 1 coffee-growing village in Nicaragua located at 1,000 m above sea level (MASL) altitude was performed. Predictors included participant sex, age, occupation, conventional CKD risk factors and other factors associated with CKD suggested by previous surveys in Central America. Outcomes included serum creatinine (SCr) values >1.2 mg/dL for men and >0.9 mg/dL for women, estimated glomerular filtration rate (GFR) <60 ml/min per 1.73 m2, dipstick proteinuria stratified as microalbuminuria (30-300 mg/dL) and macroalbuminuria (>300 mg/dL), hypertension and body mass index. Results: Of 324 eligible participants, 293 were interviewed (90.4%), and 267 of those received the physical exam (82.4% overall). Of the sample, 45% were men. Prevalence rate of estimated GFR <60 ml/min per 1.73 m2 was 0 for men (0%) and 2 for women (1.4%). The prevalence of at least microalbuminuria was significantly higher among men compared with women (27.5% vs. 21.4%, respectively; p=0.02). Conclusions: The CKD prevalence in this village is comparable to a previously studied Nicaraguan coffee-farming region and much lower than previously screened portions of northwestern Nicaragua. There is heterogeneity in CKD prevalence across Nicaragua. At this time, screenings should target individuals living in previously identified, higher risk regions. More work is needed to understand determinants of CKD in this resource-poor nation.

Article History

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Authors

  • Laux, Timothy S. [PubMed] [Google Scholar]
    University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania - USA
  • Bert, Philip J. [PubMed] [Google Scholar]
    Faculty of Medicine, National Autonomous University of Nicaragua at León, León - Nicaragua
  • Barreto Ruiz, Gerardo M. [PubMed] [Google Scholar]
    Faculty of Medicine, National Autonomous University of Nicaragua at León, León - Nicaragua
  • González, Marvin [PubMed] [Google Scholar]
    Research Centre on Health, Work and Environment, National Autonomous University of Nicaragua at León, León - Nicaragua
  • Unruh, Mark [PubMed] [Google Scholar]
    Renal-Electrolyte Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania - USA gua
  • Aragon, Aurora [PubMed] [Google Scholar]
    Research Centre on Health, Work and Environment, National Autonomous University of Nicaragua at León, León - Nicaragua
  • Torres Lacourt, Cecilia [PubMed] [Google Scholar]
    Research Centre on Health, Work and Environment, National Autonomous University of Nicaragua at León, León - Nicaragua; and Occupational and Environmental Medicine, Department of Medical Sciences, Uppsala University, Uppsala - Sweden

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