Report From the Third International Workshop on Chronic Kidney Diseases of Uncertain/Non-Traditional Etiology in Mesoamerica and Other Regions March 20-22, 2019 San José, Costa Rica Workshop organized by: Consortium for the Epidemic of Nephropathy in Central America and Mexico (CENCAM), National Institutes of Health: National Institute of Environmental Health Sciences (NIEHS) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), and World Health Organization Regional Offices: Pan American Health Organization (PAHO) and South-East Asia Regional Office (SEARO) Workshop organizing committee (in alphabetical order): Daniel Brooks (CENCAM), Ricardo Correa-Rotter (CENCAM), Jennifer Crowe (CENCAM), Marvin González-Quiroz (CENCAM), Kristina Jakobsson (CENCAM), Bonnie Joubert (NIEHS), Paul Kimmel (NIDDK), Ty Lawson (NIEHS), Susan Mendley (NIDDK), Brittany Trottier (NIEHS) Technical Series SALTRA Central American Program for Health, Work, and Environment (SALTRA) www.saltra.una.ac.cr 616.61 T14r Third International Workshop on Chronic Kidney Diseases of Uncertain/Non-Ttraditional Etiology in Mesoamerica and Other Regions (2019 Mar. 20-22: San José, Costa Rica) Report from the Third International Workshop on Chronic Kidney Diseases of Uncertain/Non-Traditional Etiology in Mesoamerica and Other Regions Editors: Jennifer L. Crowe, Bonnie R. Joubert, Daniel R. Brooks – Heredia, C.R.: SALTRA/IRET- UNA, 2020. 118 páginas: ilustraciones a color, fotografía. (Serie Salud; Trabajo y Ambiente; n° 36). Publicado también con la serie: Informe técnicos IRET, n° 38 ISBN 978-9968-924-35-1 1. RIÑONES, 2. ENFERMEDADES, 3. NEFROLOGIA, 4. EPIDEMIOLOGIA, 5. FISIOPATOLOGÍA, 6. ENFERMEDADES DEL APARATO URINARIO, 7. PLAGUICIDAS, 8. TRABAJO, 9. AGRICULTURA, 10. ENFERMEDADES OCUPACIONALES, 11. MESOAMÉRICA I. Crowe, Jennifer, editor, II. Bonnie, Joubert, editor, III. Brooks, Daniel, editor, IV. Título, V. SALTRA, VI. IRET- UNA. Editors Jennifer L. Crowe SALTRA, IRET Universidad Nacional, Costa Rica Bonnie R. Joubert National Institute of Environmental Health Sciences, National Institutes of Health, USA Daniel R. Brooks Boston University School of Public Health, USA ©SALTRA SALTRA and the editors of this report invite you to reproduce and use the material in this report to inform research, health care, prevention, and policy efforts to lessen the effects of chronic kidney disease of unknown origin. There is no charge and you do not need permission. However, we ask that you please cite both the report, as well as the individual authors of any part of the report you use. Recommended citation Crowe J.L., Joubert B.R., Brooks. D.R. (Eds.). (2020). Report From the Third International Workshop on Chronic Kidney Diseases of Uncertain/Non-Traditional Etiology in Mesoamerica and Other Regions. Heredia, Costa Rica: SALTRA. Correspondence to: Jennifer L. Crowe SALTRA- IRET-UNA [email protected] Bonnie R. Joubert National Institute of Environmental Health Sciences National Institutes of Health, USA [email protected] Table of Contents About This Report ............................................................................................................................................................................................................1 Sobre este informe ......................................................................................................................................................................................................... 2 Executive Summary ....................................................................................................................................................................................................... 3 Background .................................................................................................................................................................................................................. 3 Workshop content and structure ...................................................................................................................................................................... 4 Working groups ......................................................................................................................................................................................................... 4 Analytical Epidemiology ..................................................................................................................................................................................... 4 Biomarkers of Abnormal Kidney Function .................................................................................................................................................. 4 Clinical Presentation and Treatment .............................................................................................................................................................. 5 Heat Load/Dehydration and Workload ......................................................................................................................................................... 5 Molecular Approaches to CKDu: Genetics, epigenetics, and infectious disease ......................................................................... 6 Pathology .................................................................................................................................................................................................................. 7 Pesticides and Metals ........................................................................................................................................................................................... 8 Surveillance and Screening ............................................................................................................................................................................... 9 Conclusions ............................................................................................................................................................................................................10 Resumen Ejecutivo .......................................................................................................................................................................................................11 Antecedentes .............................................................................................................................................................................................................11 Contenido y estructura del taller ....................................................................................................................................................................12 Grupos de trabajo ...................................................................................................................................................................................................12 Epidemiologia Analítica ....................................................................................................................................................................................12 Biomarcadores de la Función Renal Anormal ..........................................................................................................................................13 Presentación Clínica y Tratamiento ..............................................................................................................................................................13 Carga de Calor/Deshidratación y Carga de Trabajo ...............................................................................................................................14 Enfoques Moleculares de ERCu: Genética, Epigenética y Enfermedades Infecciosas .............................................................14 Patología ..................................................................................................................................................................................................................16 Plaguicidas y Metales .........................................................................................................................................................................................16 Vigilancia y Tamizaje ...........................................................................................................................................................................................18 Conclusiones .........................................................................................................................................................................................................19 Workshop Purpose, Content, and Structure ..................................................................................................................................................20 Background ..................................................................................................................................................................................................................20 Pre-workshop meeting for clinical training ....................................................................................................................................................20 History of workshops ...............................................................................................................................................................................................21