Department of Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Department of Nephrology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
BMC Nephrol. 2020 May 4;21(1):159. doi: 10.1186/s12882-020-01804-x.
Mesoamerican nephropathy (MeN) is a pattern of chronic kidney disease (CKD) prevalent among Central American men who work in agriculture, and its underlying cause has not been elucidated. Currently, experts hypothesize that MeN is related to repeated episodes of occupational heat stress leading to water loss and hence it is also called dehydration-associated CKD.
We report a case of a 40-year-old man, whose first admission to Peking Union Medical College Hospital was due to acute kidney injury (AKI). The clinical and pathological processes were consistent with acute tubular necrosis (ATN). However, after full recovery, CKD developed 1 year later. The second renal biopsy showed characteristics of ischemic renal disease but there was no evidence of vascular disease. It is worth noting that the patient had been taking part in long-distance running without drinking adequate water for years, which would have markedly decrease his renal blood flow. Thus, this patient may have developed chronic dehydration-associated kidney disease sharing the similar etiology of MeN.
We report here a case of dehydration-associated CKD in a Chinese patient which shared similar etiology to MeN. Even in non-agricultural areas, this etiology of CKD should be noted to obtain a relevant history and prompt diagnosis.
中美洲肾病（MeN）是一种在中美洲从事农业工作的男性中流行的慢性肾脏病（CKD）模式，其根本原因尚未阐明。目前，专家推测 MeN 与反复发生的职业性热应激有关，导致水分流失，因此也称为与脱水相关的 CKD。
我们报告了一例 40 岁男性的病例，他首次入住北京协和医学院医院是由于急性肾损伤（AKI）。临床和病理过程与急性肾小管坏死（ATN）一致。然而，完全恢复后，1 年后出现 CKD。第二次肾活检显示出缺血性肾病的特征，但没有血管疾病的证据。值得注意的是，该患者多年来一直参加长跑而没有饮用足够的水，这会明显减少他的肾血流量。因此，该患者可能患有慢性与脱水相关的肾脏病，其病因与 MeN 相似。
我们在此报告一例中国患者的与脱水相关的 CKD 病例，其病因与 MeN 相似。即使在非农业地区，也应注意这种 CKD 的病因，以获取相关病史并及时诊断。
