Research Centre on Health, Work and Environment, National Autonomous University of Nicaragua at León, León, Nicaragua.
Am J Kidney Dis. 2010 Mar;55(3):485-96. doi: 10.1053/j.ajkd.2009.12.012. Epub 2010 Feb 8.
End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua.
Cross-sectional survey.
SETTING & PARTICIPANTS: Total populations aged 20-60 years of 5 villages in Northwest Nicaragua: mining/subsistence farming (elevation, 100-300 m above sea level), banana/sugarcane (100-300 m), fishing (0-100 m), services (0-100 m), and coffee (200-675 m); 479 men and 617 women (83% response).
Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors.
Serum creatinine (SCr) values greater than laboratory reference range for sex, estimated glomerular filtration rate <60 mL/min/1.73 m(2), proteinuria stratified in the low (dipstick protein excretion, 30-300 mg/dL) and high (>300 mg/dL) range.
Prevalences of abnormal SCr levels: 18% (of all men) and 5% (of all women); in the mining/subsistence farming village, 26% and 7%; banana/sugarcane, 22% and 6%; fishing, 13% and 4%; services, 0% and 1%; and coffee, 7% and 0%. Prevalences of estimated glomerular filtration rate <60 mL/min/1.73 m(2): 14% (of all men) and 3% (of all women); in the listed villages, 19% and 5%, 17% and 4%, 10% and 2%, 0% and 0%, and 7% and 0%, respectively. Proteinuria, predominantly in the low range, affected 14% and 11% of all men and women without marked differences between villages. By occupation, abnormal SCr levels occurred in 31% and 24% of male and female agricultural workers at 100-300 m above sea level, but not at higher altitudes, and also was high in male artisans (43%), construction workers (15%), and miners (14%). In logistic regression models, for the banana/sugarcane and mining/subsistence farming villages, high blood pressure and age were significant predictors of abnormal SCr levels in men, and for mining/subsistence farming, age in women.
Causality is not addressed.
In some Nicaraguan villages and population segments, men in particular show a high prevalence of decreased kidney function of unknown origin, possibly environmental or occupational.
终末期肾病使中美洲的卫生服务不堪重负。我们确定了尼加拉瓜受影响最严重地区不同人群中肾功能下降的患病率。
横断面调查。
尼加拉瓜西北部 5 个村庄 20-60 岁的总人口：采矿/自给农业（海拔 100-300 米）、香蕉/甘蔗（100-300 米）、渔业（0-100 米）、服务业（0-100 米）和咖啡（200-675 米）；479 名男性和 617 名女性（83%的回应率）。
村庄；参与者的性别、年龄和职业；传统的慢性肾脏病危险因素。
异常血清肌酐（SCr）水平的患病率：18%（所有男性）和 5%（所有女性）；在采矿/自给农业村，26%和 7%；香蕉/甘蔗，22%和 6%；渔业，13%和 4%；服务业，0%和 1%；咖啡，7%和 0%。肾小球滤过率<60mL/min/1.73m²的患病率：14%（所有男性）和 3%（所有女性）；在上述村庄中，19%和 5%，17%和 4%，10%和 2%，0%和 0%，7%和 0%。蛋白尿主要为低水平，影响 14%和 11%的男性和女性，各村庄之间无明显差异。按职业划分，海平面 100-300 米的农业工人中，男性和女性分别有 31%和 24%的 SCr 水平异常，但在较高海拔地区则没有，男性手工艺人（43%）、建筑工人（15%）和矿工（14%）的 SCr 水平也很高。在逻辑回归模型中，对于香蕉/甘蔗和采矿/自给农业村，男性中高血压和年龄是 SCr 水平异常的显著预测因子，而对于采矿/自给农业，女性中年龄是 SCr 水平异常的显著预测因子。
未解决因果关系。
在一些尼加拉瓜村庄和人群中，男性，特别是那些在海平面 100-300 米的农业工人，表现出高患病率的肾功能下降，其病因可能是环境或职业因素。
