As kidney disease kills thousands across continents, scientists scramble for answers

[Jeannie Barbieri-Low]

Re: As kidney disease kills thousands across continents, scientists scramble for answers

Contributing the latest studies behind this epidemic, MEDICC Review journal published "Chronic Kidney Disease Hits Agricultural Communities". www.medicc.org/mediccreview MEDICC Review is the first peer-reviewed journal to devote an entire issue to this epidemic. An emerging type of CKD of uncertain etiology (CKDu), not attributable to risk factors such as diabetes or hypertension, is devastating poor rural communities. It has particularly targeted young men who work in the fields in countries such as El Salvador, Nicaragua, Costa Rica, Mexico, Sri Lanka, Egypt and India.

Authors from seven countries (Sri Lanka, Nicaragua, El Salvador, Cuba, Italy, Mexico, and the USA) examine the epidemic: including El Salvador?s Minister of Health and the president of the International Society of Nephrology. All articles are open access, free online. www.medicc.org/mediccreview

Also, the New York Times published a feature story on CKDu yesterday.

Deadly Illness in Nicaragua Baffles Experts
The New York Times, Heather Murphy (May 8, 2014)
http://www.nytimes.com/2014/05/09/world/americas/deadly-illness-in-nicaragua-baffles-experts.html?hp

...."Across Central America, a painful disease that affects the kidneys has killed at least 20,000 people over the past decade and has become the leading cause of deaths in hospitals among men in El Salvador. But the illness, often called Chronic Kidney Disease of unknown causes, or CKDu, is so poorly understood that it still does not have a universally agreed upon name."

MEDICC Review is pleased to be the first link in the online version of the New York Times piece (universally agreed upon name) and to contribute to the science behind finding the causes.

 

[Ronan Kelly]

Re: As kidney disease kills thousands across continents, scientists scramble for answers

Welcome to FluTrackers, Jeannie Barbieri-Low. Thank you for providing the links. :tiphat:

 

[sharon sanders]

Re: As kidney disease kills thousands across continents, scientists scramble for answers

Welcome Jeannie Barbieri-Low.

 

[Emily]

Re: As kidney disease kills thousands across continents, scientists scramble for answers

Pesticide linked to three generations of disease (adult onset kidney disease, ovarian disease and obesity)

 

[Ronan Kelly]

Mysterious disease may be tied to climate change, researcher says
The kidney ailment has killed 20,000 since 2002

David Kelly
University Communications
October 8, 2015

AURORA, Colo. ? A mysterious kidney disease that has killed over 20,000 people in Central America, most of them sugar cane workers, may be caused by chronic, severe dehydration linked to global climate change, according to a new study by Richard J. Johnson, MD, of the University of Colorado Anschutz Medical Campus.

?This could be the first epidemic directly caused by global warming,? said Johnson, professor of medicine at the University of Colorado School of Medicine and a world-renowned expert on the underlying causes of obesity, kidney disease, diabetes and hypertension. ?Some districts of Nicaragua have been called the `land of widows? due to the high mortality rates occurring among the male workers from chronic kidney disease.?

The epidemic was first described in 2002 and has been dubbed Mesoamerican Nephropathy. It?s most prevalent among manual laborers on sugar cane plantations in the hotter, lower altitudes of Central America?s Pacific coast. The disease has also been reported among farmworkers, miners, fishermen and construction and transportation workers in the region.

Theories abound about what may be causing it, including exposure to heavy metals, pesticides and other toxic chemicals. But Johnson believes the actual culprit is chronic recurrent dehydration.
...
<iframe width="560" height="315" src="https://www.youtube.com/embed/yEN74QMHgOM" frameborder="0" allowfullscreen></iframe>
...
http://cuanschutztoday.org/mysterious-disease-linked-to-climate-change/

 

[Emily]

[h=1][/h] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945589/

Jayasumana C, Gunatilake S, Senanayake P. Glyphosate, Hard Water and Nephrotoxic Metals: Are They the Culprits Behind the Epidemic of Chronic Kidney Disease of Unknown Etiology in Sri Lanka? International Journal of Environmental Research and Public Health. 2014;11(2):2125-2147. doi:10.3390/ijerph110202125. [h=2]Abstract[/h] The current chronic kidney disease epidemic, the major health issue in the rice paddy farming areas in Sri Lanka has been the subject of many scientific and political debates over the last decade. Although there is no agreement among scientists about the etiology of the disease, a majority of them has concluded that this is a toxic nephropathy. None of the hypotheses put forward so far could explain coherently the totality of clinical, biochemical, histopathological findings, and the unique geographical distribution of the disease and its appearance in the mid-1990s. A strong association between the consumption of hard water and the occurrence of this special kidney disease has been observed, but the relationship has not been explained consistently. Here, we have hypothesized the association of using glyphosate, the most widely used herbicide in the disease endemic area and its unique metal chelating properties. The possible role played by glyphosate-metal complexes in this epidemic has not been given any serious consideration by investigators for the last two decades. Furthermore, it may explain similar kidney disease epidemics observed in Andra Pradesh (India) and Central America. Although glyphosate alone does not cause an epidemic of chronic kidney disease, it seems to have acquired the ability to destroy the renal tissues of thousands of farmers when it forms complexes with a localized geo environmental factor (hardness) and nephrotoxic metals.

...

[h=2]2. Compound X[/h] If we assume that the ?Compound X? is derived from the agrochemicals and is easily bound to Ca/Mg/Sr/Fe to ultimately cause damage to the kidneys, then this hypothesis can explain the geographical distribution of CKDu as well as the occurrence of the disease only after the 1990s. Political changes instituted in 1977 in Sri Lanka, have lead to economic policies that allowed the importation and application of agrochemicals on a large scale, especially for paddy farming. The low concentration of a cumulative nephrotoxin and its bioaccumulation could have taken 12?15 years to cause damage to the kidneys leading up to the level of clinically identifiable CKD. The increase in prevalence of CKDu and the shifting of age at diagnosis to younger age groups over the years are highly suggestive of the cumulative nature of the toxin. Furthermore, a comparatively low amount of agrochemicals has been used in the Northern Province of Sri Lanka, primarily due to a prohibition imposed by the government in this province. The prohibition was due to the potential of these agrochemicals being used in the production of Improvised Explosive Devices (IEDs). These IEDs were used abundantly by armed groups of the terrorist movement that plagued the country until 2009 for causing mass destruction. This is the explanation for the fact that CKDu is still not prevalent in the farming areas of the Northern Province of Sri Lanka where the ground water hardness has remained high. Based upon these observations, here we summarizes the expected properties of the chemical Compound ?X? that is hypothesized as the incriminating agent of CKDu.

• (a)
  A compound made of recently (2?3 decades) introduced chemicals to the CKDu endemic area.
• (b)
  Ability to form stable complexes with hard water.
• (c)
  Ability to capture and retain arsenic and nephrotoxic metals and act as a ?carrier? in delivering these toxins to the kidney.
• (d)
  Possible multiple routes of exposure: ingestion, dermal and respiratory absorption.
• (e)
  Not having a significant first pass effect when complexed with hard water.
• (f)
  Presenting difficulties in identification when using conventional analytical methods.

The present authors have continuously searched for a possibility of Compound X over the time period of interest and noticed that aminophosphonic acid or aminophosphonate (known by the common chemical name glyphosate) is the most widely used herbicide in the contemporary world [17] as well as in Sri Lanka. The amount of glyphosate exceeded the sum of all other pesticides imported into Sri Lanka in 2012 (Table 1) [18]. The former Stauffer Chemical Company (Westport, CT, USA) initially obtained a patent for aminophosphonic acid as a chelating agent, wetting agent and biologically active compound [19]. Glyphosate was initially used as a descaling agent to clean out calcium and other mineral deposits in pipes and boilers of residential and commercial hot water systems. Descaling agents are effective metal binders, which grab on to Ca, Mg, etc. ions and make the metal water soluble and easily removable. Later, the Monsanto Company has acquired the chemical from Stauffer and obtained a patent for aminophosphonate for its herbicidal properties [20].

...

[h=2]3. CKDu Elsewhere[/h] A CKDu epidemic very similar to that of Sri Lanka has been identified among the paddy farmers in Andra Pradesh?a southeastern province of India [94]. These authors reported that ground water is the only available water source in Uddanam and Chikamurthy, two of the areas with the highest CKDu prevalence. Analysis of samples of drinking water revealed that metal ions and trace elements in drinking water were within allowable limits, and thus not expected to lead to any deleterious effects on human health. However, in these findings it was clearly shown that the total hardness, Ca, Mg and Sr values are quite high. Especially in Chikamurthy area, some of the drinking water samples exceed 1,000 mg/L of total hardness. The authors may not have paid enough attention to this finding as hardness is not identified as a nephrotoxin or as causing significant human health problems, apart from being a suggested risk factor for exacerbation of eczema [13]
...

...Glyphosate is the leading pesticide used in El Salvador as well [103]. If we apply the same hypothesis to explain the CKDu in CA it can logically explain the occurrence of disease among male farm workers in pacific coastal line. The CA Pacific coastal line belongs to the volcanic belt [104,105]. In this region soil and groundwater naturally contain high amounts of metals and As [106]....

 

[Emily]

http://modernfarmer.com/2017/07/the-killing-fields/

[h=1]The Killing Fields[/h] By Brian Barth on July 31, 2017
Photographs by Ed Kashi

...

Many of the Sri Lankan farmers Kashi spoke to suspected that the illness stems from contaminated drinking water. Arsenic, cadmium, and other heavy metals found in synthetic fertilizers and pesticides frequently surface in the country?s groundwater. Channa Jayasumana, Ph.D., a medical toxicologist at Sri Lanka?s Rajarata University, believes there?s no single smoking gun, but rather a confluence of factors at play, among them: malnutrition, chronic dehydration, a prevalence of infectious diseases like leptospirosis, and the interaction between groundwater supplies and agricultural chemicals. Specifically, his research focuses on whether those chemicals and heavy metals, along with the water?s naturally occurring calcium and magnesium, are forming new, more acutely toxic compounds. Jayasumana notes that glyphosate, the active ingredient in Monsanto?s Roundup, was originally patented in part as a chelating agent?a substance that readily binds with metals?and may act as a vector, carrying heavy metals to the kidneys. Though Monsanto vigorously denies Jayasumana?s claims, he counters that the corporation tests its products in temperate Western countries. ?Our research shows that pesticides behave differently depending on climate, soil type, and groundwater conditions. It is the duty of Monsanto to show that these chemicals are not toxic in other parts of the world,? says the doctor.
Meanwhile, the Sri Lankan government isn?t taking any chances. President Maithripala Sirisena instituted a national ban on glyphosate upon taking office in 2015. Pesticides containing propanil, carbaryl, chlorpyrifos, or carbofuran had already been outlawed in 2014. Yet farmers continue to purchase the prohibited products at inflated black-market prices.

 

[Ronan Kelly]

The ?silent massacre? killing El Salvador?s sugarcane workers
Feb 28, 2018 6:20 pm EST


A mysterious, chronic kidney disease is wreaking havoc on farm workers in Central America, particularly those who harvest sugar. Despite the risks, Salvadoran cane cutters continue the grueling work, pushed by economic troubles. Special correspondent Fred de Sam Lazaro reports on how some are trying to improve work conditions in El Salvador.
...
Dr. Ramon Garcia is a kidney specialist in El Salvador?s capital, San Salvador.

Dr. Ramon Garcia:

Seven to eight deaths every day in this small country is 10, 12 times more than the expected death rate. This is a silent massacre.
...
Initially, pesticides were considered a likely culprit, but there was no explanation why these chemicals didn?t have a similar impact in other places they are sprayed, including the United States.

Dr. Garcia says one thing they believe may be a contributing factor is the severe dehydration of the workers, which prevents the kidneys from functioning fully.

Dr. Ramon Garcia:

It?s too hot, simply too hot. You cannot drink enough water at the same pace that you are losing it in sweat. It?s impossible. We?re not sure if this is the real cause, the only cause, or there?s a mix of many causes that, put together, are producing the disease.
...
https://www.pbs.org/newshour/show/t...l&utm_source=facebook.com&utm_campaign=buffer

 

[Shiloh]

Source: https://www.sciencedaily.com/releases/2020/11/201113095156.htm

An epidemic outbreak of Mesoamerican Nephropathy in Nicaragua linked to nickel toxicity
Date:
November 13, 2020
Source:
Baylor College of Medicine
Summary:
For over 20 years, researchers have tried to solve the medical mystery behind Mesoamerican Nephropathy, a form of chronic kidney disease that has caused more than 50,000 deaths in coastal South America. Now, researchers present the strongest evidence to date on the cause of the disease in one of the worst-hit hotspots in the region, Nicaragua, using an unlikely source, the toenails of individuals with the disease.

For more than 20 years, an epidemic of chronic kidney disease (CKD) of unknown origin has severely affected specific coastal communities along South America's Pacific coastline from Mexico to Panama leading to more than 50,000 deaths. The condition, known as Mesoamerican Nephropathy (MeN), has a perplexing clinical presentation. Unlike traditional forms of CKD, it affects healthy young working-age individuals who do not have other traditional risk factors for kidney disease, such as diabetes or hypertension. The underlying cause of this devastating public health crisis has remained a mystery.

A "CSI-style" scientific investigation led by Dr. Kristy Murray, professor of pediatrics, immunology and microbiology at Baylor College of Medicine and Texas Children's Hospital, revealed evidence for nickel toxicity as the underlying cause of this disease in a Nicaraguan "hotspot," which is among the worst-hit areas in the continent. The study provides new, compelling evidence that low-dose exposure to nickel can cause systemic inflammation, anemia and kidney injury -- hallmarks of acute MeN that progresses to chronic kidney disease in around 90% of the patients. The study appeared in PLoS ONE this week....

...Journal Reference:

• Rebecca S. B. Fischer, Jason M. Unrine, Chandan Vangala, Wayne T. Sanderson, Sreedhar Mandayam, Kristy O. Murray. Evidence of nickel and other trace elements and their relationship to clinical findings in acute Mesoamerican Nephropathy: A case-control analysis. PLOS ONE, 2020; 15 (11): e0240988 DOI: 10.1371/journal.pone.0240988