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Personalized Nutrition in Chronic Kidney Disease
Published in Nilanjana Maulik, Personalized Nutrition as Medical Therapy for High-Risk Diseases, 2020
Conversely, almost all kidney diseases of the young are more common in medium and low-income countries; interstitial and infectious diseases are more prevalent where sanitary conditions are suboptimal; diseases with toxic and environmental causes (e.g. Mesoamerican nephropathy) are more frequent in the developing world; immunologic diseases occur more frequently in some ethnic groups (such as Latin-Americans), and may be triggered by infectious or inflammatory diseases (Hoy, White et al. 2015; Benghanem Gharbi, Elseviers et al. 2016; Lozano-Kasten, Sierra-Diaz et al. 2017). The obesity and diabetes epidemics have not spared low-income countries, where preventive measures and early diagnosis of CKD are less available. As a consequence, age-adjusted incidence of CKD is higher in low-income countries, even when the overall burden of disease may be lower, due to the presence of competitive mortality (Figure 9.4) (Kovesdy, Furth et al. 2017a).
Kidney biomarkers in tropical infections: an update
Published in Pathogens and Global Health, 2020
Daniella Bezerra Duarte, Maria Carolina Santa Rita Lacerda, Yara Janaína Porto Ribeiro, Maria Zenaide Dias Ribeiro, Matheus de Almeida Frederico, Michelle Jacintha Cavalcante Oliveira
To explore the relationship between leptospirosis and Mesoamerican Nephropathy (MeN), condition of unknown etiology and not associated with common causes of CKD, a recent study evaluated the prevalence of Leptospira seropositivity among 282 workers employed in a region where MeN is common in Nicaragua; estimated incident cases of leptospirosis among sugarcane workers within one harvest season; and determined whether Leptospira seropositivity was associated with biomarkers of kidney function and injury: NGAL, interleukin-18 (IL-18) and NAG. Leptospira seroprevalence differed among job categories and was highest among sugarcane cutters (59%). Biomarkers of kidney injury were significantly elevated among seropositive sugarcane workers at late-harvest when adjusting only for sex, age, and years worked. This association was attenuated by 15–22% when the model additionally included job category as a covariate, suggesting that job category is acting as a proxy for an unmeasured exposure that is causing the elevation in biomarkers of kidney injury. However, Leptospira infection may be acting as a kidney disease susceptibility factor, given the higher concentrations of biomarkers among seropositive workers [33].
Acute toxic kidney injury
Published in Renal Failure, 2019
Nadezda Petejova, Arnost Martinek, Josef Zadrazil, Vladimir Teplan
The fatal, rapidly progressive chronic kidney disease and unremitting epidemic of inexplicable acute failure of renal function in agricultural workers and communities, especially in sugar canes cutters is known as Mesoamerican nephropathy. A some research has been done on chemicals, heavy metals and also on potential infection etiology. The disease is common in countries of Central America: Nicaragua, Guatemala, El Salvador, Costa Rica and Honduras. Due to the estimated number of deaths of 20 000 to 2010 [66], the Pan American Health Organization at the 52nd Directing Council in 2013 adopted a fundamental position on disease control, surveillance and follow-up. According to the results, the disease is most common in underprivileged young men and workers on farms with an extensive health, social and economic burden on affected countries. The causes appear to be multifactorial, including environmental toxins (e.g., agrichemicals) in combination with the occupational risks of high temperatures and inadequate rehydration with water intake [67]. The acute form of the disease presents with gastrointestinal disorders (nausea and vomiting), arthralgia, headache, myalgia, weakness, back pain, neurological symptoms as paresthesia and tingling sensation. An aspect of the condition has been linked by some authors to infection etiology, e.g., leptospirosis and hantavirosis as neglected tropical diseases but this is not a single causative factor [68]. The pathophysiological mechanisms of selected environmental and (agri)chemical nephrotoxicity are presented in Figure 3.