Original InvestigationPathogenesis and Treatment of Kidney DiseaseDecreased Kidney Function Among Agricultural Workers in El Salvador
Section snippets
Study Design and Setting
The study was requested by the Salvadorian health authorities. Approval was obtained from the Bioethical Review Board of the Universidad Nacional in Costa Rica because there was no such entity in El Salvador at the time. All participants signed informed consent.
We selected 5 communities in El Salvador. Sugarcane production was the dominant economic activity in 2 sea-level communities on the Pacific Coast, 1 rural and 1 semirural. Previously, cotton production was important in these communities.
Study Setting and Participant Characteristics
We examined 664 persons with no exclusions (Table 1). The participation rate was 73%: 77% for women and 66% for men. The lowest response was 49% (men in the coffee community) and the highest was 86% (men in the high-altitude sugarcane community). The main reasons for refusal were no interest and anxiety about providing a blood sample. Nonresponders were of similar age as participants.
By design, there were marked differences in altitudes and economic activity between the communities and hence in
Discussion
This study provides further evidence of a CKD epidemic in Central America and data for several key characteristics. The main findings were: (1) high prevalences of elevated SCr levels and decreased eGFRs in coastal sugarcane communities with infrequent low-grade proteinuria; (2) a lower prevalence for women than men, but with similar trends over pertinent categories; (3) gradient for elevated SCr levels with years of coastal sugarcane or cotton work in men and women; and (4) no increase in
Acknowledgements
The authors acknowledge the dedication during difficult field work of assistants Gabriela Ponce, Vladimir Menjivar, Denise Membreño, David Ramírez, Jessica Ramírez, and Víctor Ramírez. We are grateful for the support from the staff at the Chemical Section of the Clinical Laboratory and nephrologists at the Nephrology Unit of Hospital Rosales and from Salvador Castillo, Dean of the Faculty of Chemistry and Pharmacy of the University of El Salvador. We thank the leaders of the different
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Originally published online February 10, 2012.
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Deceased.