Causes of Chronic Kidney Disease of Non-Traditional Origin in Central America: An Approach Based on Medical Geology

Abstract

Chronic kidney disease of non-traditional origin (CKDnt) in Central America, also known as Mesoamerican Nephropathy (MeN), is of particular concern in agricultural populations. The member states of the Central American Integration System (SICA) determined in 2013 that there was an imperative need to address the situation in a comprehensive manner and defined policies for the intervention of the disease. A situation that currently worries health authorities is that cases are on the rise—without distinguishing or implementing effective actions to achieve a decrease in disease prevalence. The incidence of heat and strenuous activities on renal health is undeniable; however, labeling these variables as the only responsible causes for MeN has not catalyzed the implementation of health measures to lead to a preventive approach to solve the epidemic or to achieve a decrease in the number of new cases. This review addresses the role nephrotoxic metals present in the environment, mainly in soils and water, may have as part of a scenario of exposure to environmental toxins in which environmental, occupational, geographic and population variables interact. An integral approach was used to encompass the multicausality that is attributed to MeN and based on the multidisciplinary concept of the re-emerging discipline called medical geology.