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Mesoamerican nephropathy

Carl-Gustaf Elinder, MD, PhD
Annika O Wernerson, MD, PhD
Section Editor
Paul M Palevsky, MD
Deputy Editor
Alice M Sheridan, MD


Mesoamerican nephropathy (MeN), formerly called chronic kidney disease of unknown cause (CKDu) [1], refers to CKD that presents in young, agricultural workers in Central America in the absence of any clear etiology [2-5]. There is no specific treatment of MeN, other than that for nonproteinuric CKD from any other cause.

This topic reviews MeN. The treatment of CKD is discussed elsewhere. (See "Overview of the management of chronic kidney disease in adults".)


The entity of MeN was first suggested when it was noted that a high percentage of patients initiated on dialysis in El Salvador had no obvious cause of chronic kidney disease (CKD) [6,7]. In a hospital study, among 205 patients initiated on dialysis between 1999 and 2000, the cause of end-stage renal disease (ESRD) was unknown in 135 patients [6].

A number of subsequently published studies revealed a high prevalence of CKD of unknown etiology in specific regions of El Salvador and Nicaragua, Guatemala, and Costa Rica [4,8]:

In one study of 291 men from the coastlands of El Salvador, the prevalence of previously undiagnosed CKD (defined by creatinine ≥1.5 mg/dL) was 13 percent [9]. Of these, only 38 percent had diabetes or hypertension (which are common causes of CKD in other areas), while the remainder did not appear to have a clear-cut cause for CKD. By contrast, the prevalence of CKD in the United States is approximately 5 percent [10]. (See "Epidemiology of chronic kidney disease".)


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Literature review current through: Feb 2017. | This topic last updated: Thu Sep 22 00:00:00 GMT 2016.
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