Published Papers
An explorative study of inflammation-related proteins associated with kidney injury in male heat-stressed workers
Investigators
Erik Hansson, Jason Glaser, Julia Wijkström, Kristina Jakobsson
Journal
Journal of Thermal Biology
Published date:
21 Jan 2023
Excerpt
Chronic kidney disease of non-traditional origin (CKDnt) and acute kidney injury (AKI) often affect heat-stressed Mesoamerican manual workers. Inflammation occurs concurrently with AKI in this population, but its role remains unknown. To explore links between inflammation and kidney injury in heat stress, we compared levels of inflammation-related proteins in cutters with and without increasing serum creatinine levels during sugarcane harvest. These sugarcane cutters have previously been identified to be repeatedly […]
Association Between Acute Kidney Injury Hospital Visits and Environmental Heat Stress at a Nicaraguan Sugarcane Plantation
Investigators
David Wegman
Journal
Workplace Health and Safety
Published date:
9 Apr 2024
Excerpt
Background: Mesoamerican sugarcane cutters are at a high risk of chronic kidney disease of non-traditional origin, a disease likely linked to heat-related acute kidney injury (AKI). Studies in general populations have described a positive association between high environmental temperatures and clinically assessed kidney outcomes, but there are no studies in occupational settings. Method: We accessed routine records of clinically diagnosed AKI (AKI-CD) and wet bulb globe temperatures (WBGT) at a […]
Challenges and opportunities in interventions for chronic kidney disease of unknown origin (CKDu): report from the International Society of Nephrology Consortium of Collaborators on CKDu
Investigators
David Wegman
Journal
Kidney International
Published date:
1 Jan 2023
Excerpt
In 2016, the International Society of Nephrology convened the International Consortium of Collaborators on Chronic Kidney Disease of Unknown Etiology, which has reported on disease detection strategies2 and on methods to elucidate the cause of CKDu.1 Recognizing the urgent need for preventative and diseasemodifying therapies, International Consortium of Collaborators on Chronic Kidney Disease of Unknown Etiology presents this commentary as a starting point for researchers seeking to mitigate the burden […]
Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress
Investigators
Kristina Jakobsson
Journal
Pan American Journal of Public Health
Published date:
27 Jan 2020
Excerpt
The death toll of the epidemic of chronic kidney disease of nontraditional origin (CKDnt) in Mesoamerica runs into the tens of thousands, affecting mostly young men. There is no consensus on the etiology. Anecdotal evidence from the 1990s pointed to work in sugarcane; pesticides and heat stress were suspected. Subsequent population-based surveys supported an occupational origin with overall high male-female ratios in high-risk lowlands, but small sex differences within occupational […]
Chronic kidney disease of unknown etiology: a disease related to global warming?
Investigators
Jason Glaser, Richard Johnson
Journal
MEDICC Review
Published date:
10 May 2014
Excerpt
Chronic kidney disease (CKD) is increasingly common throughout the world, largely due to the burgeoning epidemics of obesity and diabetes. Not only are diabetic nephropathy and hypertension the two most common causes of end-stage renal disease, but persons with obesity and metabolic syndrome also frequently show early signs of kidney disease well before diabetes and high blood pressure become apparent. Thus, a major focus has been on identifying the underlying […]
CKDu: Strategies for saving lives now
Investigators
Ilana Weiss
Journal
MEDICC Review
Published date:
1 Apr 2014
Excerpt
La Isla Foundation (LIF) is a nongovernmental organization based in Nicaragua that works at the intersection of health and human rights. LIF was created to address the fatal epidemic of chronic kidney disease of nontraditional causes (CKDu) in the context of its impact on sugarcane workers in Central America. In the town of Chichigalpa, the epicenter of the Nicaraguan epidemic, mortality from CKDu has more than doubled in the last […]
Climate change and nephrology
Investigators
Jaime Butler-Dawson
Journal
Nephrology Dialysis Transplantation
Published date:
2 Sep 2021
Excerpt
Climate change should be of special concern for the nephrologist, as the kidney has a critical role in protecting the host from dehydration, but it is also a favorite target of heat stress and dehydration. Here we discuss how rising temperatures and extreme heat events may affect the kidney. The most severe presentation of heat stress is heat stroke, which can result in severe electrolyte disturbance and both acute and […]
Climate Change and the Emergent Epidemic of CKD from Heat Stress in Rural Communities: The Case for Heat Stress Nephropathy
Investigators
Richard Johnson
Journal
Clinical Journal of the American Society of Nephrology
Published date:
8 Aug 2016
Excerpt
Climate change has led to significant rise of 0.8°C-0.9°C in global mean temperature over the last century and has been linked with significant increases in the frequency and severity of heat waves (extreme heat events). Climate change has also been increasingly connected to detrimental human health. One of the consequences of climate-related extreme heat exposure is dehydration and volume loss, leading to acute mortality from exacerbations of pre-existing chronic disease, […]
Comment: Mesoamerican nephropathy–new evidence and the need to act now
Investigators
Catharina Wesseling
Journal
International Journal of Occupational and Environmental Health
Published date:
23 Jul 2015
Excerpt
We welcome the publication “Changes in kidney function among Nicaraguan sugarcane workers,”Citation1 which raises important issues regarding the Mesoamerican nephropathy (MeN), an epidemic of chronic kidney disease (CKD) of non-traditional etiology (CKDnT) – not explained by known risk factors. This epidemic along the Pacific coast of Mesoamerica has caused the death of many thousands of workers over decades in multiple countries, but only recently has it become known in the […]
Decline in Kidney Function among Apparently Healthy Young Adults at Risk of Mesoamerican Nephropathy
Investigators
Catharina Wesseling
Journal
Journal of the American Society of Nephrology
Published date:
1 Aug 2018
Excerpt
Background Epidemic levels of CKD of undetermined cause, termed Mesoamerican nephropathy in Central America, have been found in low- and middle-income countries. We investigated the natural history of, and factors associated with, loss of kidney function in a population at high risk for this disease.Methods We conducted a 2-year prospective, longitudinal study with follow-up every 6 months in nine rural communities in northwestern Nicaragua and included all men (n=263) and […]
Dying for sport
Investigators
Jason Glaser
Journal
Occupational & Environmental Medicine
Published date:
7 Dec 2021
Excerpt
Public health professionals in host coun- tries can help address the critical health needs of immigrants, but for migrant workers there is a particular need for the focused attention of the occupational health community. One case where that community must be more engaged was documented by Amnesty International: ‘In the prime of their lives’ Qatar’s failure to investigate, remedy and prevent migrant workers’ deaths.1 There is good evidence that the […]
Effects on household income and earnings from chronic kidney disease of non-traditional origins: PREP project findings from Chichigalpa, Nicaragua
Investigators
William Martinez-Cuadra
Journal
Occupational Environmental Medicine
Published date:
20 May 2024
Excerpt
Objective: Our purpose with this study is to examine the socioeconomic outcomes associated with chronic kidney disease not related to well-known risk factors (CKDnt) in four communities in Chichigalpa, Nicaragua that are home to a substantial number of sugarcane workers. Methods: We employed a cluster-based systematic sampling design to identify differences in outcomes between those households affected directly by CKDnt and those that are not. Results: Overall, we find that […]
