UC Irvine

Contrary to the conventional definition of CKD that is observed in developed countries, studies on CKD in developing countries demonstrate an atypical presentation of the disease, referenced as CKD of unknown origin (CKDu). CKD rates have been exponentially increasing in Nicaragua, particularly in sugarcane workers. This study assesses risk factors associated with this atypical presentation of CKD in patients from an occupational health clinic in rural Nicaragua. This was a cross-sectional study that included 512 patient records (2009 to 2014). Records were randomly selected and transcribed into an electronic database. The data was analyzed with a case-control perspective comparing patients with CKD from those without the disease. A logistic regression analysis was performed in order to examine the personal and occupational risks associated with CKD. Results of this study showed that patients with CKD were predominantly men, approximately ten years younger than patients without CKD, more commonly worked in agriculture, and had a lower prevalence of diabetes and hypertension. Regarding records of past medical history, there was poor agreement between physicians and patients. Moreover, the logistic regression model demonstrated that agricultural work has a 24-fold increase in the risk of CKD, which is not confounded by known risk factors for CKD. In conclusion, this study further characterizes the atypical presentation of CKD in Nicaragua. This study uniquely focuses on a specific population of workers that has not been previously studied. It also examines the association between particular occupational hazards and CKD, thus, furthering the understanding of CKD in Nicaragua.