Prevalence and Risk Factors for CKD in the General Population of Southwestern Nicaragua
CLINICAL EPIDEMIOLOGY www.jasn.org Prevalence and Risk Factors for CKD in the General Population of Southwestern Nicaragua Ryan Ferguson,1 Sarah Leatherman,2 Madeline Fiore,3 Kailey Minnings,4 Martha Mosco,5 James Kaufman,6 Eric Kerns,7 Juan Jose Amador,8 Daniel R. Brooks,8 Melissa Fiore,9 Rulan S. Parekh,4,10 and Louis Fiore8 Due to the number of contributing authors, the affiliations are listed at the end of this article. ABSTRACT Background Studies have described Mesoamerican nephropathy among agricultural workers of El Salva- dor and northwestern Nicaragua. Data on prevalence and risk factors for CKD beyond agricultural workers and in other regions in Nicaragua are sparse. Methods We recruited participants from 32 randomly selected communities in the Department of Rivas’s ten municipalities in two phases. In phase 1, we screened participants using a field-based capillary creat- inine measuring system and collected self-reported information on lifestyle and occupational, exposure, and health histories. Two years later, in phase 2, we enrolled 222 new participants, performing serum creatinine testing in these participants and confirmatory serum creatinine testing in phase 1 participants. Results We enrolled 1242 of 1397 adults (89%) living in 533 households (median age 41 years; 43% male). We confirmed CKD (eGFR,60 ml/min per 1.73 m2) in 53 of 1227 (4.3%) evaluable participants. In multivari- able testing, risk factors for prevalent CKD included age (odds ratio [OR], 1.92; 95% confidence interval [95% CI], 1.89 to 1.96) and self-reported history of hypertension (OR, 1.95; 95% CI, 1.04 to 3.64), diabetes (OR, 2.88; 95% CI, 1.40 to 5.93), or current or past work in the sugarcane industry (OR 2.92; 95% CI, 1.36 to 6.27).
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