Prevalence of and risk factors for chronic kidney disease in rural Nicaragua

  • O'Donnell J
  • Tobey M
  • Weiner D
 et al. 
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Background. Mostly anecdotal reports describe a high prevalence of chronic kidney disease in northwestern Nicaragua, predominantly among younger men, resulting in substantial morbidity and mortality. The true prevalence, nature and aetiology of kidney disease in this region remain unknown.
Methods. We performed a population-based prevalence study in Quezalguaque, Nicaragua to assess the frequency of estimated glomerular filtration rate (eGFR) Results. From 1882 eligible households, 771 individuals from 300 households participated in the prevalence study, 98 (13%) of whom had reduced eGFR. Reduced eGFR was more common among older participants, men and participants living at lower altitudes. Among 18–29-year-old participants, 2.6% had reduced eGFR, and among 30–41-year-old participants, 7.4% had reduced eGFR; this compares with 0.2% and 0.8%, respectively, in NHANES. No individuals in these age groups were diabetic. Among cases, only 27% had dipstick proteinuria of 1+ or greater, compared with 7% of controls. Haematuria did not significantly differ between cases and controls (24% versus 18%). In age- and sex-adjusted models, hypertension and residence at lower altitude were independently associated with reduced eGFR, while occupational history was not associated with reduced eGFR.
Conclusions. Kidney disease appears common in residents of Quezalguaque, Nicaragua, particularly in younger men, with features most consistent with tubulointerstitial disease. Further research is needed to elucidate the causes of kidney disease in this region.

Author-supplied keywords

  • Latin America
  • Nicaragua
  • chronic kidney disease
  • epidemiology
  • prevalence

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  • Julie K. O'Donnell

  • Matthew Tobey

  • Daniel E. Weiner

  • Lesley A. Stevens

  • Sarah Johnson

  • Peter Stringham

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