ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2016
Urine biomarkers of kidney injury among adolescents in Nicaragua, a region affected by an epidemic of chronic kidney disease of unknown aetiology.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it, 78 citations in OpenAlex.
- Pediatric kidney health outcomes in communities impacted by chronic kidney disease of unknown etiology (CKDu): a systematic review.Pediatric nephrology (Berlin, Germany) · 2026Pooled it
- Environmental exposures and pediatric kidney function and disease: A systematic review.Environmental research · 2017Pooled it
- Paediatric chronic kidney disease of unknown aetiology: early-life origins, detection, and prevention.Pediatric nephrology (Berlin, Germany) · 2026Review
- Kidney health among adolescents living in a high-risk region for CKDu.BMC nephrology · 2026Article
- Uncovering potential biomarkers for chronic kidney disease of unknown etiology through a network-based bioinformatic approach.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Toenail metal concentrations and kidney health among young people at risk of chronic kidney disease of uncertain etiology.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Genetic Factors Related to the Development or Progression of Mesoamerican Endemic Nephropathy.International journal of molecular sciences · 2025Review
- Systematic Review of Kidney Injury Biomarkers for the Evaluation of CKD of Uncertain Etiology.Kidney international reports · 2024Article
- Community engagement in kidney research: Guatemalan experience.BMC nephrology · 2022Article
- Urinary biomarkers indicate pediatric renal injury among rural farming communities in Sri Lanka.Scientific reports · 2022Article
- Urinary cystatin C: pediatric reference intervals and comparative assessment as a biomarker of renal injury among children in the regions with high burden of CKDu in Sri Lanka.World journal of pediatrics : WJP · 2022Article
- Where do you live and what do you do? Two questions that might impact your kidney health.Frontiers in nephrology · 2022Review
- Urinary Biomarkers of Renal Injury KIM-1 and NGAL: Reference Intervals for Healthy Pediatric Population in Sri Lanka.Children (Basel, Switzerland) · 2021Article
- Biomarkers of kidney injury among children in a high-risk region for chronic kidney disease of uncertain etiology.Pediatric nephrology (Berlin, Germany) · 2021Article
- Factors associated with chronic kidney disease of non-traditional causes among children in Guatemala.Revista panamericana de salud publica = Pan American journal of public health · 2021Article
- The Utility of Novel Renal Biomarkers in Assessment of Chronic Kidney Disease of Unknown Etiology (CKDu): A Review.International journal of environmental research and public health · 2020Review
- Workplace Screening Identifies Clinically Significant and Potentially Reversible Kidney Injury in Heat-Exposed Sugarcane Workers.International journal of environmental research and public health · 2020Article
- Kidney Function, Self-Reported Symptoms, and Urine Findings in Nicaraguan Sugarcane Workers.Kidney360 · 2020Article
- Prevalence and risk factors for chronic kidney disease of unknown cause in Malawi: a cross-sectional analysis in a rural and urban population.BMC nephrology · 2020Article
- Is an Environmental Nephrotoxin the Primary Cause of CKDu (Mesoamerican Nephropathy)? PRO.Kidney360 · 2020Article
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundAn epidemic of chronic kidney disease (CKD) of non-traditional aetiology has been recently recognized by health authorities as a public health priority in Central America. Previous studies have identified strenuous manual work, agricultural activities and residence at low altitude as potential risk factors; however, the aetiology remains unknown. Because individuals are frequently diagnosed with CKD in early adulthood, we measured biomarkers of kidney injury among adolescents in different regions of Nicaragua to assess whether kidney damage might be initiated during childhood.
methodsParticipants include 200 adolescents aged 12-18 years with no prior work history from four different schools in Nicaragua. The location of the school served as a proxy for environmental exposures and geographic locations were selected to represent a range of factors that have been associated with CKD in adults (e.g. altitude, primary industry and CKD mortality rates). Questionnaires, urine dipsticks and kidney injury biomarkers [interleukin-18, N-acetyl-d-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL) and albumin-creatinine ratio] were assessed. Biomarker concentrations were compared by school using linear regression models.
resultsProtein (3.5%) and glucose (1%) in urine measured by dipstick were rare and did not differ by school. Urine biomarkers of tubular kidney damage, particularly NGAL and NAG, showed higher concentrations in those schools and regions within Nicaragua that were defined a priori as having increased CKD risk. Painful urination was a frequent self-reported symptom.
conclusionsAlthough interpretation of these urine biomarkers is limited because of the lack of population reference values, results suggest the possibility of early kidney damage prior to occupational exposures in these adolescents.
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