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In reply to: “Should we consider renaming ‘Mesoamerican Nephropathy’ as Nephropathy of Unknown Cause in Agricultural Labourers (NUCAL)?”
  1. Ramón García-Trabanino1,2,
  2. Kristina Jakobsson3,
  3. Carolina Guzmán Quilo4,
  4. Daniel R Brooks5,
  5. Jennifer Crowe6,
  6. Joaquín Barnoya7,8,
  7. Magdalena Madero9,
  8. Marvin González Quiroz10,11,
  9. Catharina Wesseling12,
  10. David H Wegman13,
  11. Ricardo Correa-Rotter14
  1. 1 Centro de Hemodiálisis, San Salvador, El Salvador
  2. 2 Emergency Social Fund for Health of Tierra Blanca, Tierra Blanca, El Salvador
  3. 3 Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
  4. 4 Faculty of Chemistry and Pharmacy, Universidad de San Carlos, Guatemala, Guatemala
  5. 5 Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
  6. 6 Regional Institute for Studies on Toxic Substances (IRET), Program on Health, Work and Environment (SALTRA), Universidad Nacional, Heredia, Costa Rica
  7. 7 Research Department, Cardiovascular Surgery Unit, Guatemala, Guatemala
  8. 8 Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
  9. 9 Division of Nephrology, Department of Medicine, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico city, Mexico
  10. 10 Research Center on Health, Work and Environment (CISTA), National Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua
  11. 11 Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  12. 12 Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
  13. 13 Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
  14. 14 Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico city, Mexico
  1. Correspondence to Dr Ramón García-Trabanino, Calle Gabriela Mistral 211, 1101, San Salvador, El Salvador; rgt{at}anhaes.org

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We, from the Consortium on the Epidemic of Nephropathy in Central America and Mexico (CENCAM), read with interest Drs Subramanian and Javaid's letter,1 regarding Mesoamerican Nephropathy (MeN), a name assigned to a type of chronic kidney disease (CKD) not related to classic risk factors and also referred to as CKD of unknown (CKDu) or non-traditional causes. MeN is highly prevalent in Central America and a major health problem.2

We agree with the authors that it is important to focus attention on the occupational component of this disease, …

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