Mesoamerican Nephropathy in Central Panama

Abstract

Abstract Background In the last three decades, there has been an increase in the frequency of patients diagnosed with chronic kidney disease of nontraditional causes (CKDnt) in the Mesoamerican region. A region with an increased frequency of patients with chronic kidney disease (CKD) has been identified in central Panama. The present study aims to characterize the clinical presentation of patients with CKDnt in an understudied population of the central region of Panama and compare them with patients with traditional CKD (CKDt). Methods A retrospective descriptive study was conducted in a nephrology reference hospital in the central provinces of Herrera and Los Santos, comparing a group of 15 patients with CKDnt to 91 patients with CKDt. Sociodemographic variables, personal history, laboratory parameters, and of renal ultrasound were compared. Results CKDnt is more common among relatively younger male patients who engage in strenuous work activities at high temperatures. CKDnt is not associated with type 2 diabetes mellitus or chronic hypertension, as it is the case in patients with CKDt. Renal atrophy and hyperuricemia are significant clinical markers of CKDnt. Conclusion To our knowledge, this is the first study in Panama and one of the few in Central America and the world to address the clinical presentation of patients with CKDnt compared to patients with CKDt. Because CKDnt remains asymptomatic for a long time, early detection is important, and efforts should be directed at halting disease progression at an early stage. Current evidence can also inform policies addressing occupational and environmental risk factors associated with CKDnt.