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Leptospira seropositivity as a risk factor for Mesoamerican Nephropathy

Alejandro Riefkohl1, Oriana Ramírez-Rubio1,2, Rebecca L Laws3

  • 1a Department of Epidemiology , Boston University School of Public Health , Boston , MA , USA.

International Journal of Occupational and Environmental Health
|February 18, 2017
PubMed
Abstract

Insights

Leptospira seroprevalence was highest in sugarcane cutters, with some indication of a link to kidney injury biomarkers. Further research is needed to confirm if Leptospira infection contributes to Mesoamerican Nephropathy in Central American workers.

Area of Science:

  • Occupational Health
  • Infectious Diseases
  • Nephrology

Background:

  • Mesoamerican Nephropathy (MeN) is a chronic kidney disease affecting Central American workers.
  • Leptospirosis, a bacterial infection, is a suspected but unconfirmed cause of MeN.

Purpose of the Study:

  • To determine job-specific Leptospira seroprevalence in Central American workers.
  • To investigate the association between Leptospira seropositivity and kidney disease biomarkers.

Main Methods:

  • Assessed anti-leptospiral antibodies in 489 workers (sugarcane, other industries).
  • Measured serum creatinine and urinary biomarkers: neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and N-acetyl-D-glucosaminidase (NAG).

Main Results:

  • Leptospira seroprevalence varied by job, highest in sugarcane cutters (59%).
  • Seropositive workers showed higher NGAL levels (relative mean: 1.28) than seronegative workers.
  • Associations between seropositivity and other biomarkers were inconsistent.

Conclusions:

  • Leptospira seroprevalence differs significantly across job roles.
  • Preliminary evidence suggests a possible link between Leptospira infection and kidney injury biomarkers.
  • More research is required to establish Leptospira's role in Mesoamerican Nephropathy.
Keywords:
Chronic kidney disease (CKD)Chronic kidney disease of nontraditional etiology (CKDnt)IeptospirosisInterleukin-18 (IL-18)LeptospiraMesoamerican Nephropathy (MeN)N-acetyl-D- glucosaminidase (NAG)Neutrophil gelatinase-associated lipocalin (NGAL)

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