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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. 1Centro de Hemodiálisis, San Salvador, El Salvador
  2. 2Emergency Social Fund for Health of Tierra Blanca, Tierra Blanca, El Salvador
  3. 3Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Goteborg, Sweden
  4. 4Faculty of Chemistry and Pharmacy, Universidad de San Carlos, Guatemala, Guatemala
  5. 5Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
  6. 6Regional Institute for Studies on Toxic Substances (IRET), Program on Health, Work and Environment (SALTRA), Universidad Nacional, Heredia, Costa Rica
  7. 7Research Department, Cardiovascular Surgery Unit, Guatemala, Guatemala
  8. 8Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
  9. 9Division of Nephrology, Department of Medicine, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico city, Mexico
  10. 10Research Center on Health, Work and Environment (CISTA), National Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua
  11. 11Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
  12. 12Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
  13. 13Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts, USA
  14. 14Department 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}

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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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