Projects: Mesoamerican nephropathy – a devastating epidemic

Chronic Kidney Disease, CKD, is increasing in both developed and developing countries, greatly expanding the need for chronic dialysis and renal transplantation. A widespread epidemic of CKD of uncertain etiology has been detected in Central America and Mexico and been named Mesoamerican nephropathy, MeN. The epidemic occurs mainly among sugar cane cutters, working under extremely hot conditions, and in lesser extent also among workers in several other hot occupations. Reports of a similar kind have been published from Sri Lanka and Thailand. A wide variety of etiologies have been proposed, including exposure to herbicides, pesticides, heavy metals, toxins , drugs (NSAIDs), infections, metabolic causes, and the effects of heat stress and recurrent dehydration.  A multifactorial etiology is likely with long-term occupational heat stress and recurrent dehydration as a necessary factor. IMM researchers have studied the epidemic for 10 years and are involved in several epidemiologic projects that aim to identify the causes of MeN and to evaluate work place interventions against dehydration and heat stress in a broad international collaboration. We are also leaders of CENCAM (Consortium on the Epidemic of Nephropathy in Central America and Mexico) where many North and South American as well as European researchers are members.