Pediatric Nephrology Unit, Fundacion Para el Niño Enfermo Renal (FUNDANIER), Guatemala City, Guatemala; Department of Pediatrics, Hospital Roosevelt, Guatemala City, Guatemala.
Nephrology Division, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Health Policy and Management, University of Toronto, Ontario, Canada; Hospital Infantil de México Federico Gómez, Ciudad de México, México.
Semin Nephrol. 2022 Sep;42(5):151337. doi: 10.1016/j.semnephrol.2023.151337. Epub 2023 Apr 5.
Mesoamerican endemic nephropathy (MeN) is a type of chronic kidney disease (CKD) of uncertain etiology that occurs along the Pacific coast of the southern part of Mexico and Central America. During the past 20 years MeN has become a leading cause of death in the region, clamming close to 50,000 lives, with 40% of these deaths occurring in young people. The cause remains unknown, but most researchers believe in a multifactorial etiology that includes social determinants of poverty. Existing evidence suggests that subclinical kidney injury begins early in life and leads to a higher than expected prevalence of CKD among children in Central America. Access to health services in the region, specifically kidney replacement therapy, remains limited. We proposed a strategy to address the perceived needs and urge coordinated efforts of governments, academic organizations, and international bodies to develop a comprehensive plan of action to mitigate this situation among the vulnerable and economically disadvantaged population.
中美洲地方性肾病(MeN)是一种病因不明的慢性肾脏病(CKD),发生在墨西哥南部和中美洲太平洋沿岸。在过去的 20 年中,MeN 已成为该地区的主要死亡原因,夺走了近 5 万人的生命,其中 40%的死亡发生在年轻人中。病因仍不清楚,但大多数研究人员认为其病因是多因素的,包括贫困的社会决定因素。现有证据表明,亚临床肾脏损伤早在生命早期就开始发生,并导致中美洲儿童中 CKD 的患病率高于预期。该地区的卫生服务,特别是肾脏替代治疗的可及性仍然有限。我们提出了一项策略来应对人们的需求,并敦促政府、学术组织和国际机构协调努力,制定一项全面行动计划,以减轻弱势和经济贫困人群的这种情况。