Cardiovascular and Renal Risk Factors in the Argentine First Nations: A Study of the Qom and Wichi Indigenous Groups

The "10 Recommendations for Global Kidney Health" developed at the Global Policy 2017 constitute a commitment by and challenge to all stakeholders. Achieving these goals in disadvantaged population such as the First Nation Peoples (FNP) is even more challenging. Qom and Wichi ethnics are isolated Argentine FNP with poor access to health care. Research on chronic kidney disease (CKD) in Qom FNP in the Chaco Province, Argentina showed high rates of proteinuria without a decrease of the glomerular filtration rate in a group of 385 persons in 2003. In 2018, a subsequent cross-sectional evaluation in those individuals still living in the area revealed that diabetes mellitus (DM) increased sixfold (from 2% to 14%) and obesity increased threefold (from 21% to 61%). Infections (tuberculosis) and cardiovascular disease were the main causes of mortality in the whole sample, whereas gynecologic cancer was the first cause of death in women and cardiovascular disease in men. In 2018, a new group of subjects (not those originally assessed in 2003) showed a remarkably high prevalence of renal risk factors despite being as young as those originally evaluated in 2003 but with a prevalence of renal risk factors as high as when the latter were assessed 15 years afterward. Wichi FNP, in 2020, showed lower proteinuria rates (14%) with virtually no presence of DM. FNP deserve the creation of public policies for CKD detection and treatment, but they must be based on local scientific evidence, with continuous monitoring and learning and scalable strategies.