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Mesoamerican Nephropathy (MeN) is a currently unexplained epidemic of chronic kidney disease of unknown origin (CKDu),〔 prevalent in the Pacific ocean coastal low lands of the mesoamerican region, including southern Mexico, Guatemala, El Salvador, Nicaragua, Honduras and Costa Rica. In rural areas of Nicaragua the disease is colloquially called creatinina. This CKD epidemic in Central America spans along a nearly 1000 kilometer stretch of the Pacific coast. In El Salvador and Nicaragua alone, the reported number of men dying from this painful disease has risen five-fold in the last 20 years, although some researchers believe hidden cases have always been there and this increment in official data could be partially due to the recent increase in reports and improved case search, pushed by the growing social and political interest in the disease. In El Salvador, the disease has become the second leading cause of death among adult men, and according to a recent editorial,〔 〕 it has been estimated that this largely unknown epidemic has caused the premature death of at least 20,000 men in the region.〔 〕 Science Magazine reports: "In El Salvador alone, PAHO's latest figures say CKD of all causes kills at least 2,500 people in the country each year".〔 〕〔 〕 The people affected by the epidemic are mainly young and middle-aged male laborers in the agricultural sector,〔 〕〔 〕 particularly sugarcane workers.〔 〕〔 〕 The disease has also been found to be prevalent in other occupations implying strenuous work (miners, construction, port and transportation workers)〔〔〔 〕〔 〕 in the high temperatures of the coastlands. The epidemic appears to affect particular Pacific coastal regions of Nicaragua,〔〔〔 El Salvador,〔〔〔 Costa Rica,〔 〕〔 〕 and Guatemala.〔 〕 ==History== The real timeline of the disease is unknown since most of the aforementioned countries did not have or still lack renal disease registries, and the affected regions are mainly poor farm lands. Nicaraguan health authorities have commented that they have been noting an increase of CKD cases in the Pacific ocean coastal regions since the 80s, but it was not until 2002 that a scientific paper from an El Salvadoran reference hospital〔 first communicated and described the existence of an important group of CKDu patients with a particular epidemiological pattern. In January 2005, a second scientific paper,〔 〕 also from El Salvador, reported some field efforts on trying to identify the cause of the disease, and confirmed its curious epidemiological pattern. In November 2005, (SALTRA ), a university-based Program on Work and Health in Central America (SALTRA), organized a regional interdisciplinary workshop in Leon, Nicaragua, attended by 17 researchers from the involved countries and international experts. There, the existence of the disease —also referred to as CKDu— was first acknowledged, and collaboration was established throughout the region. In November 2012, the Consortium for the Epidemic of Nephropathy in Central America and Mexico ((CENCAM )) was established in a subsequent SALTRA organized workshop in San Jose, Costa Rica, to promote further research on the disease, in order to improve knowledge about the epidemic, and to use it to reduce CKDu prevalence and incidence in the region. The full Final Technical Report from the 2012 MeN workshop is available from (www.regionalnephropathy.org ). In April 2013, a high-level meeting with regional health ministries, nongovernmental organizations, aid agencies, clinical specialists and researchers was held in San Salvador city, El Salvador, leading the Panamerican Health Organization (PAHO) to finally declare CKDu "a pressing and extremely serious health problem in the region". The Declaration described CKD as having “catastrophic effects associated with toxic-environmental and occupational factors, dehydration and behaviors harmful to renal health". In it, the Ministers of Health of the Central American Integration System (the Spanish acronym ) declared their commitment to address CKDu comprehensively and to “strengthening scientific research in the framework of the prevention and control of chronic non-communicable diseases.”〔Declaración de San Salvador. Abordaje integral de la enfermedad renal túbulo-intersticial crónica de Centroamérica (ERTCC) que afecta predominantemente a las comunidades agrícolas. Available in: http://www.salud.gob.sv/archivos/comunicaciones/archivos_comunicados2013/pdf/Declaracion_San%20Salvador_ERCnT_26042013.pdf Accessed March 2, 2014.〕 This Declaration was subsequently endorsed by PAHO through the Resolution CD52.R1, adopted in the 52nd Directing Council, 65th Session of the Regional Committee of WHO for the Americas, in October 2013.〔Pan American Health Organization. Resolution CD52.R1. Chronic kidney disease in agricultural communities in Central America. Washington, DC. 2013. Available at: http://www.paho.org/hq/index.php?option=com_content&view=article&id=8833&Itemid=40033&lang=en Accessed June 13, 2013〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Mesoamerican nephropathy」の詳細全文を読む スポンサード リンク
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