Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies
Date
2016-11Metadata
Show full item recordAbstract
Over the last two decades, experts have reported a rising
number of deaths caused by chronic kidney disease (CKD)
along the Pacific coast of Central America, from southern
Mexico to Costa Rica. However, this specific disease is not
associated with traditional causes of CKD, such as aging,
diabetes, or hypertension. Rather, this disease is a chronic
interstitial nephritis termed chronic kidney disease of nontraditional etiology (CKDnT). According to the Pan
American Health Organization (PAHO) mortality database,
there are elevated rates of deaths related to kidney disease in
many of these countries, with the highest rates being reported
in El Salvador and Nicaragua. This condition has been identified
in certain agricultural communities, predominantly
among male farmworkers. Since CKD surveillance systems
in Central America are under development or nonexistent,
experts and governmental bodies have recommended creating
standardized case definitions for surveillance purposes
to monitor and characterize this epidemiological situation. A
group of experts from Central American ministries of health,
the U.S. Centers for Disease Control and Prevention (CDC),
and PAHO held a workshop in Guatemala to discuss CKDnT
epidemiologic case definitions. In this paper, we propose that
CKD in general be identified by the standard definition
internationally accepted and that a suspect case of CKDnT
be defined as a person age < 60 years with CKD, without
type 1 diabetes mellitus, hypertensive diseases, and other
well-known causes of CKD. A probable case of CKDnT is
defined as a suspect case with the same findings confirmed
three or more months later. En los dos últimos decenios, los expertos han notificado un
aumento del número de defunciones causadas por enfermedad
renal crónica (ERC) a lo largo de la costa del Pacífico
de Centroamérica, desde el sur de México hasta Costa Rica.
Sin embargo, esta enfermedad específica no está asociada con
las causas tradicionales de ERC, como envejecimiento, diabetes
o hipertensión. En cambio, esta enfermedad es una
nefritis intersticial crónica denominada enfermedad renal
crónica de causas no tradicionales (ERCnT). Según la base
de datos de mortalidad de la Organización Panamericana de
la Salud (OPS), se registran tasas de mortalidad elevadas
relacionadas con la enfermedad renal en muchos de estos
países; las más elevadas se informaron en El Salvador y
Nicaragua. Esta enfermedad ha sido identificada en algunas
comunidades agrícolas, predominantemente en trabajadores agrícolas varones. Como los sistemas de vigilancia de la ERC
en Centroamérica están en desarrollo o son inexistentes, los
expertos y los organismos gubernamentales han recomendado
elaborar definiciones de caso estandarizadas con fines de vigilancia,
para monitorear y caracterizar esta situación epidemiológica.
Un grupo de expertos de los ministerios de
salud centroamericanos, los Centros para el Control y la
Prevención de Enfermedades de los Estados Unidos (CDC) y
la OPS se reunieron en un taller realizado en Guatemala
para debatir posibles definiciones de caso epidemiológicas de
ERCnT. En este artículo proponemos que, en general, la
ERC se identifique mediante la definición normalizada internacionalmente
aceptada y que un caso presunto de ERCnT
se defina como: persona menor de 60 años con ERC, sin diabetes
mellitus de tipo I, enfermedades hipertensivas ni otras
causas conocidas de ERC; y un caso probable de ERCnT se
defina como un caso presunto con los mismos resultados
confirmados tres meses después o más.
Translated title
Enfermedad renal crónica de causas no tradicionales en Centroamérica: una definición de caso provisional para vigilancia y estudios epidemiológicos
Subject
Citation
Lozier M, Turcios-Ruiz RM, Noonan G, Ordunez P. Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies. Rev Panam Salud Publica. 2016;(40)5:294-300.
Collections
Related items
Showing items related by title, author, creator and subject.
-
Ferreiro, Alejandro; Álvarez-Estévez, Guillermo; Cerdas-Calderón, Manuel; Cruz-Trujillo, Zulma; Mena, Elio; Reyes, Marina; Sandoval-Diaz, Mabel; Sánchez-Polo, Vicente; Valdés, Régulo; Ordúnez, Pedro (2016-11)Over the last 20 years, many reports have described an excess of cases of chronic kidney disease (CKD) in the Pacific coastal area of Central America, mainly affecting male farmworkers and signaling a serious public ...
-
Wesseling, Catharina; Glaser, Jason; Rodríguez-Guzmán, Julieta; Weiss, Ilana; Lucas, Rebekah; Peraza, Sandra; Soares da Silva, Agnes; Hansson, Erik; Johnson, Richard J.; Hogstedt, Christer; Wegman, David H.; Jakobsson, Kristina (2020)[ABSTRACT]. The death toll of the epidemic of chronic kidney disease of nontraditional origin (CKDnt) in Mesoamerica runs into the tens of thousands, affecting mostly young men. There is no consensus on the etiology. ...
-
Pan American Health Organization (PAHOUnited StatesWashington, D.C, 2017)In the last four decades, increasing numbers of young people, in clusters of vulnerable farming communities in several Central American countries, have developed a severe form of kidney failure of uncertain etiology (thus ...