Jessica H Leibler1, Oriana Ramirez-Rubio2,3, Juan José Amador Velázquez3, Damaris López Pilarte3, Wassim Obeid4, Chirag R Parikh4, Salini Gadupudi3, Madeleine K Scammell5, David J Friedman6, Daniel R Brooks3. 1. Department of Environmental Health, Boston University School of Public Health, 715 Albany St., 430W, Boston, MA, 02118, USA. jleibler@bu.edu. 2. Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain. 3. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA. 4. Division of Nephrology, Department of Medicine, Johns Hopkins Medicine, Baltimore, MD, USA. 5. Department of Environmental Health, Boston University School of Public Health, 715 Albany St., 430W, Boston, MA, 02118, USA. 6. Division of Nephrology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Abstract
BACKGROUND: Mesoamerican Nephropathy (MeN), a form of chronic kidney disease of uncertain etiology, is a leading cause of death in Central America. The disease often presents in young adult male agricultural workers and progresses rapidly. Given the young age at presentation, we hypothesized that children in Central America experience subclinical kidney injury prior to working life. METHODS: We assessed specimens from a cross-sectional study of youth, aged 7-17 years, predominantly residing in a high-risk region of Nicaragua (n = 210). We evaluated urinary concentrations and risk factors for kidney injury biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), monocyte chemoattractant protein 1 (MCP-1), and chitinase-3-like protein 1 (YKL-40). We evaluated the association between biomarkers and contemporaneous eGFR and compared biomarker concentrations with reference values from healthy children in other countries. RESULTS: Median uNGAL, uIL-18, and uKIM-1 concentrations exceeded healthy reference values. A one-year increase in age was associated with 40% increase in odds of being in the highest quartile of uNGAL (OR 1.4; (95%CI 1.2, 1.5); p < 0.0001). Youth who reported ever experiencing dysuria had 2.5 times the odds of having uNGAL concentrations in the top quartile (OR 2.5; (95%CI 1.4, 4.6); p = 0.003). Girls had significantly higher concentrations of all biomarkers than boys. Nine percent of children demonstrated low eGFR (≤ 100 ml/min/1.73 m2), while 29% showed evidence of hyperfiltration (eGFR ≥ 160 ml/min/1.73 m2), both potentially indicative of renal dysfunction. CONCLUSIONS: Children residing in regions of Nicaragua at high risk for MeN may experience subclinical kidney injury prior to occupational exposures.
BACKGROUND: Mesoamerican Nephropathy (MeN), a form of chronic kidney disease of uncertain etiology, is a leading cause of death in Central America. The disease often presents in young adult male agricultural workers and progresses rapidly. Given the young age at presentation, we hypothesized that children in Central America experience subclinical kidney injury prior to working life. METHODS: We assessed specimens from a cross-sectional study of youth, aged 7-17 years, predominantly residing in a high-risk region of Nicaragua (n = 210). We evaluated urinary concentrations and risk factors for kidney injury biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), interleukin-18 (IL-18), monocyte chemoattractant protein 1 (MCP-1), and chitinase-3-like protein 1 (YKL-40). We evaluated the association between biomarkers and contemporaneous eGFR and compared biomarker concentrations with reference values from healthy children in other countries. RESULTS: Median uNGAL, uIL-18, and uKIM-1 concentrations exceeded healthy reference values. A one-year increase in age was associated with 40% increase in odds of being in the highest quartile of uNGAL (OR 1.4; (95%CI 1.2, 1.5); p < 0.0001). Youth who reported ever experiencing dysuria had 2.5 times the odds of having uNGAL concentrations in the top quartile (OR 2.5; (95%CI 1.4, 4.6); p = 0.003). Girls had significantly higher concentrations of all biomarkers than boys. Nine percent of children demonstrated low eGFR (≤ 100 ml/min/1.73 m2), while 29% showed evidence of hyperfiltration (eGFR ≥ 160 ml/min/1.73 m2), both potentially indicative of renal dysfunction. CONCLUSIONS: Children residing in regions of Nicaragua at high risk for MeN may experience subclinical kidney injury prior to occupational exposures.
Authors: Oriana Ramirez-Rubio; Michael D McClean; Juan José Amador; Daniel R Brooks Journal: J Epidemiol Community Health Date: 2012-09-21 Impact factor: 3.710
Authors: Catharina Wesseling; Berna van Wendel de Joode; Jennifer Crowe; Ralf Rittner; Negin A Sanati; Christer Hogstedt; Kristina Jakobsson Journal: Occup Environ Med Date: 2015-07-21 Impact factor: 4.402
Authors: Ramón García-Trabanino; Emmanuel Jarquín; Catharina Wesseling; Richard J Johnson; Marvin González-Quiroz; Ilana Weiss; Jason Glaser; Juan José Vindell; Leo Stockfelt; Carlos Roncal; Tamara Harra; Lars Barregard Journal: Environ Res Date: 2015-07-23 Impact factor: 6.498
Authors: Rebecca S B Fischer; Sreedhar Mandayam; Denis Chavarria; Chandan Vangala; Melissa S Nolan; Linda L Garcia; Lesbia Palma; Felix Garcia; Ramón García-Trabanino; Kristy O Murray Journal: Am J Trop Med Hyg Date: 2017-07-19 Impact factor: 2.345
Authors: Carlos Manuel Orantes-Navarro; Raúl Herrera-Valdés; Miguel Almaguer-López; Laura López-Marín; Xavier Fernando Vela-Parada; Marcelo Hernandez-Cuchillas; Lilly M Barba Journal: Adv Chronic Kidney Dis Date: 2017-03 Impact factor: 3.620
Authors: E M D V Ekanayake; T D K S C Gunasekara; P Mangala C S De Silva; Sudheera Jayasinghe; E P S Chandana; Nishad Jayasundara Journal: Int J Environ Res Public Health Date: 2022-04-26 Impact factor: 4.614
Authors: T D K S C Gunasekara; P Mangala C S De Silva; E M D V Ekanayake; W A K G Thakshila; R A I Pinipa; P M M A Sandamini; S D Gunarathna; E P S Chandana; S S Jayasinghe; C Herath; Sisira Siribaddana; Nishad Jayasundara Journal: Sci Rep Date: 2022-05-16 Impact factor: 4.996