{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T03:02:42Z","timestamp":1786676562034,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","funder":[{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001463","name":"American Society of Nephrology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001463","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Canada Research Chair in CKD Epidemiology"},{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007265","name":"Boston University Schools of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Public Health"},{"DOI":"10.13039\/100001463","name":"American Society of Nephrology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001463","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JASN"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>\n                      Most studies of Mesoamerican nephropathy have focused on regions in El Salvador and northwest Nicaragua and on agricultural workers, but information regarding prevalence and risk factors for CKD in Nicaragua\u2019s general population is sparse. In a study of community-dwelling individuals in southwestern Nicaragua, the authors screened 1242 participants for CKD (defined as &lt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ). Risk factors for prevalent CKD included age, diabetes, and hypertension. Current or former workers in the sugarcane industry (but not other types of agriculture) had a twofold-increased odds of CKD. CKD prevalence in southwestern Nicaragua is about 5% among the general population but is not consistent across Nicaragua. Formal CKD surveillance programs in Nicaragua are needed to assess the overall burden of CKD nationally, with a focus on agricultural workers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Studies have described Mesoamerican nephropathy among agricultural workers of El Salvador and northwestern Nicaragua. Data on prevalence and risk factors for CKD beyond agricultural workers and in other regions in Nicaragua are sparse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We recruited participants from 32 randomly selected communities in the Department of Rivas\u2019s ten municipalities in two phases. In phase 1, we screened participants using a field-based capillary creatinine measuring system and collected self-reported information on lifestyle and occupational, exposure, and health histories. Two years later, in phase 2, we enrolled 222 new participants, performing serum creatinine testing in these participants and confirmatory serum creatinine testing in phase 1 participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We enrolled 1242 of 1397 adults (89%) living in 533 households (median age 41 years; 43% male). We confirmed CKD (eGFR&lt;60 ml\/min per 1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ) in 53 of 1227 (4.3%) evaluable participants. In multivariable testing, risk factors for prevalent CKD included age (odds ratio [OR], 1.92; 95% confidence interval [95% CI], 1.89 to 1.96) and self-reported history of hypertension (OR, 1.95; 95% CI, 1.04 to 3.64), diabetes (OR, 2.88; 95% CI, 1.40 to 5.93), or current or past work in the sugarcane industry (OR 2.92; 95% CI, 1.36 to 6.27).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Adjusted CKD prevalence was about 5% with repeat confirmatory testing in southwest Nicaragua, lower than in the northwest region. Risk factors included diabetes, hypertension, and current or prior work in the sugarcane industry but not in other forms of agricultural work. Formal CKD surveillance programs in Nicaragua are needed to assess the overall burden of CKD nationally, with a focus on agricultural workers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1681\/asn.2019050521","type":"journal-article","created":{"date-parts":[[2020,5,29]],"date-time":"2020-05-29T16:55:42Z","timestamp":1590771342000},"page":"1585-1593","source":"Crossref","is-referenced-by-count":21,"title":["Prevalence and Risk Factors for CKD in the General Population of Southwestern Nicaragua"],"prefix":"10.1681","volume":"31","author":[{"given":"Ryan","family":"Ferguson","sequence":"first","affiliation":[{"name":"Boston University, School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Leatherman","sequence":"additional","affiliation":[{"name":"Boston Cooperative Studies Program Coordinating Center, Veterans Affairs, Boston Healthcare System, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeline","family":"Fiore","sequence":"additional","affiliation":[{"name":"University of Massachusetts, School of Medicine, Worcester, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kailey","family":"Minnings","sequence":"additional","affiliation":[{"name":"University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Mosco","sequence":"additional","affiliation":[{"name":"New York Presbyterian Hospital, Weill Cornell, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Veterans Affairs New York Harbor Healthcare System and New York University School of Medicine, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Kerns","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Lahey Hospital and Medical Center, Burlington, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jose","family":"Amador","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel R.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Fiore","sequence":"additional","affiliation":[{"name":"Cornell University, Ithaca, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rulan S.","family":"Parekh","sequence":"additional","affiliation":[{"name":"University of Toronto, Faculty of Medicine, Toronto, Ontario, Canada"},{"name":"Division of Nephrology, Department of Pediatrics and Medicine, Hospital for Sick Children, University Health Network, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Fiore","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,5,29]]},"reference":[{"key":"B1-20230829","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1126\/science.344.6180.143","article-title":"Mesoamerica\u2019s mystery killer","volume":"344","author":"Cohen","year":"2014","journal-title":"Science"},{"key":"B2-20230829","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1038\/nrneph.2013.174","article-title":"Chronic kidney disease: Mesoamerican nephropathy--new clues to the cause","volume":"9","author":"Johnson","year":"2013","journal-title":"Nat Rev Nephrol"},{"key":"B3-20230829","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1053\/j.ajkd.2012.01.005","article-title":"CKD in Central America: A hot issue","volume":"59","author":"Brooks","year":"2012","journal-title":"Am J Kidney Dis"},{"key":"B4-20230829","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1093\/ckj\/sfu118","article-title":"CKD hotspots around the world: Where, why and what the lessons are. 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