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- Laux, Timothy S, et al.
(författare)
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Nicaragua revisited : evidence of lower prevalence of chronic kidney disease in a high-altitude, coffee-growing village
- 2012
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Ingår i: JN. Journal of Nephrology (Milano. 1992). - : SAGE Publications. - 1121-8428 .- 1724-6059. ; 25:4, s. 533-540
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Chronic kidney disease (CKD) is found at epidemic levels in certain populations of the Pacific Coast in northwestern Nicaragua especially in younger men. There are knowledge gaps concerning CKD's prevalence in regions at higher altitudes.METHODS: A cross-sectional study of adults between the ages of 20 and 60 years in 1 coffee-growing village in Nicaragua located at 1,000 m above sea level (MASL) altitude was performed. Predictors included participant sex, age, occupation, conventional CKD risk factors and other factors associated with CKD suggested by previous surveys in Central America. Outcomes included serum creatinine (SCr) values >1.2 mg/dL for men and >0.9 mg/dL for women, estimated glomerular filtration rate (GFR) <60 ml/min per 1.73 m2, dipstick proteinuria stratified as microalbuminuria (30-300 mg/dL) and macroalbuminuria (>300 mg/dL), hypertension and body mass index.RESULTS: Of 324 eligible participants, 293 were interviewed (90.4%), and 267 of those received the physical exam (82.4% overall). Of the sample, 45% were men. Prevalence rate of estimated GFR <60 ml/min per 1.73 m2 was 0 for men (0%) and 2 for women (1.4%). The prevalence of at least microalbuminuria was significantly higher among men compared with women (27.5% vs. 21.4%, respectively; p=0.02).CONCLUSIONS: The CKD prevalence in this village is comparable to a previously studied Nicaraguan coffee-farming region and much lower than previously screened portions of northwestern Nicaragua. There is heterogeneity in CKD prevalence across Nicaragua. At this time, screenings should target individuals living in previously identified, higher risk regions. More work is needed to understand determinants of CKD in this resource-poor nation.
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| 2. |
- Laux, Timothy S., et al.
(författare)
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Revalence of hypertension and associated risk factors in six nicaraguan communities
- 2012
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Ingår i: Ethnicity & Disease. - 1049-510X. ; 22:2, s. 129-135
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Describe the prevalence of hypertension. Design: Population based cross-sectional survey. Setting: Six Nicaraguan communities with varying economies. Participants: 1,355 adults aged 20-60 years who completed both self-reported and quantitative measures of health. Main Outcome Measures: Prevalence of hypertension (systolic >= 140 mm Hg, diastolic >= 90 mm Hg, or self-reported medical history with diagnosis by a health care professional), uncontrolled hypertension (systolic >= 140 mm Hg or diastolic >= 90 mm Hg), diabetes (urinary glucose excretion >= 100 mg/dL or self-reported medical history diagnosed by a health care professional), and uncontrolled diabetes (urinary glucose excretion >= 100 mg/dL only). Results: The prevalence of hypertension was 22.0% (19.2% in men, 24.2% in women). Blood pressure was controlled in 31.0% of male hypertensives and 55.1% of female hypertensives (odds ratio [OR] 2.86; 95% confidence interval [CI] 1.74-4.69). Older age and higher body mass index were strongly associated with hypertension. Women who completed primary school had a lower risk of hypertension (OR .40; 95% CI .19-.85) compared to those with no formal education. A history of living in both urban and rural settings was associated with lower prevalence of hypertension (OR .52; 95% CI .34-.79). Diabetes mellitus was found in 1.2% of men and 4.3% of women. Male sex was independently associated with decreased risk of diabetes (OR .31; 95% CI .11-.86). Conclusions: At least one cardiovascular risk factor was found in half of this Nicaraguan sample. Cardiovascular risk factors should be the target of educational efforts, screening, and treatment.
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| 3. |
- Torres, Cecilia, et al.
(författare)
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Decreased Kidney Function of Unknown Cause in Nicaragua : A Community-Based Survey
- 2010
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Ingår i: American Journal of Kidney Diseases. - : Elsevier BV. - 0272-6386 .- 1523-6838. ; 55:3, s. 485-496
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Tidskriftsartikel (refereegranskat)abstract
- Background: End-stage kidney disease overwhelms health services in Central America. We determined prevalences of decreased kidney function in distinct populations in the most affected region of Nicaragua. Study Design: Cross-sectional survey. Setting & Participants: Total populations aged 20-60 years of 5 villages in Northwest Nicaragua: mining/subsistence farming (elevation, 100-300 m above sea level), banana/sugarcane (100-300 m), fishing (0-100 m), services (0-100 m), and coffee (200-675 m); 479 men and 617 women (83% response). Predictor or Factor: Village; participant sex, age, and occupation; conventional chronic kidney disease risk factors. Outcomes: Serum creatinine (SCr) values greater than laboratory reference range for sex, estimated glomerular filtration rate <60 mL/min/1.73 m(2), proteinuria stratified in the low (dipstick protein excretion, 30-300 mg/dL) and high (>300 mg/dL) range. Results: Prevalences of abnormal SCr levels: 18% (of all men) and 5% (of all women); in the mining/subsistence farming village, 26% and 7%; banana/sugarcane, 22% and 6%; fishing, 13% and 4%; services, 0% and 1%; and coffee, 7% and 0%. Prevalences of estimated glomerular filtration rate <60 mL/min/1.73 m2: 14% (of all men) and 3% (of all women); in the listed villages, 19% and 5%, 17% and 4%, 10% and 2%, 0% and 0%, and 7% and 0%, respectively. Proteinuria, predominantly in the low range, affected 14% and 11% of all men and women without marked differences between villages. By occupation, abnormal SCr levels occurred in 31% and 24% of male and female agricultural workers at 100-300 m above sea level, but not at higher altitudes, and also was high in male artisans (43%), construction workers (15%), and miners (14%). In logistic regression models, for the banana/sugarcane and mining/subsistence farming villages, high blood pressure and age were significant predictors of abnormal SCr levels in men, and for mining/subsistence farming, age in women. Limitations: Causality is not addressed. Conclusions: In some Nicaraguan villages and population segments, men in particular show a high prevalence of decreased kidney function of unknown origin, possibly environmental or occupational.
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