Smpokou, E;
González-Quiroz, M;
Martins, C;
Alvito, P;
Le Blond, J;
Glaser, J;
Aragón, A;
... Caplin, B; + view all
(2019)
Environmental exposures in young adults with declining kidney function in a population at risk of Mesoamerican Nephropathy.
Occupational and Environmental Medicine
, 76
(12)
pp. 920-926.
10.1136/oemed-2019-105772.
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Abstract
OBJECTIVES: There is an epidemic of Mesoamerican Nephropathy (MeN) in Central America, where sugarcane production is prominent. Numerous causes are proposed, but to date limited evidence supports any one hypothesis. A nested case-control study using biosamples from a rural, community-based follow-up study of 350 young adults from Northwest Nicaragua at risk of MeN, was conducted with the aim of characterising the associations between urinary concentrations of metals, pesticides and mycotoxins from samples collected in the first 6 months, and decline in kidney function over 2 years. // METHODS: Urine samples collected at baseline (pre-sugarcane harvest) and the first 6-month follow-up (post-sugarcane harvest) visit were tested. Twelve metals and metalloids (Al, total As, Cd, Co, Cr, Cu, Hg, Mn, Pb, Se, Si and Sr) were analysed by inductively-coupled plasma-mass spectrometry. Twelve pesticides or their metabolites (2,4-D, 3-PBA, 4F3PBA, CFCA, DCCA, ETU, glyphosate, MCPA, OH-PYM, 5-OH-TBZ, TEB-OH and TCP), and two mycotoxins (OTA and CIT), were analysed by liquid chromatography coupled mass spectrometry. Differences in the creatinine-corrected urinary concentrations of the measured exposures between outcome groups (participants with stable versus declining kidney function) were examined. // RESULTS: Elevated levels of aluminium and total arsenic as well as metabolites of several pesticides were detected across the population. No differences were identified between the declining and stable groups in the levels of metals or pesticides tested. OTA and CIT were below the limit of detection. // CONCLUSIONS: The tested metals, metalloids, pesticides and mycotoxins were not associated with loss of kidney function in participants at-risk of MeN.
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