Mesoamerican nephropathy

Mesoamerican nephropathy (MeN) is a currently unexplained epidemic of chronic kidney disease of unknown origin (CKDu), prevalent in the Pacific Ocean coastal low lands of the Mesoamerican region, including southern Mexico, Guatemala, El Salvador, Nicaragua, Honduras and Costa Rica. In rural areas of Nicaragua the disease is colloquially called creatinina. Mesoamerican nephropathy (MeN) is a currently unexplained epidemic of chronic kidney disease of unknown origin (CKDu), prevalent in the Pacific Ocean coastal low lands of the Mesoamerican region, including southern Mexico, Guatemala, El Salvador, Nicaragua, Honduras and Costa Rica. In rural areas of Nicaragua the disease is colloquially called creatinina. This CKD epidemic in Central America spans along a nearly 1000 kilometer stretch of the Pacific coast. In El Salvador and Nicaragua alone, the reported number of men dying from this painful disease has risen five-fold in the last 20 years, although some researchers believe hidden cases have always been there and this increment in official data could be partially due to the recent increase in reports and improved case search, pushed by the growing social and political interest in the disease. In El Salvador, the disease has become the second leading cause of death among adult men, and according to a recent editorial, it has been estimated that this largely unknown epidemic has caused the premature death of at least 20,000 men in the region. Science Magazine reports: 'In El Salvador alone, PAHO's latest figures say CKD of all causes kills at least 2,500 people in the country each year'. The people affected by the epidemic are mainly young and middle-aged male laborers in the agricultural sector, particularly sugarcane workers. The disease has also been found to be prevalent in other occupations with a high risk of heat stress, implying strenuous work (miners, construction, port and transportation workers) in the high temperatures of the coastlands. The epidemic appears to affect particular Pacific coastal regions of Nicaragua, El Salvador, Costa Rica, and Guatemala. The cause of MeN is unclear, but it is certainly not explained by conventional causes such as diabetes mellitus or hypertension. Many risk factors have been proposed but to date, the causes of the disease remain uncertain and controversial.