Un análisis nacional del riesgo de enfermedad renal crónica potencial de etiología desconocida en Ecuador

An increase of chronic kidney disease (CKD) has affected many tropical countries but with an atypical presentation. This illness, known as Chronic Kidney Disease of Unknown Etiology (CKDu), presents in younger adults without the typical comorbidities for CKD, often among those working in agricultural production. The cause of disease is unknown but temperature, heat stress, or dehydration are thought to contribute to the development of this condition. There is no information on whether anyone in Ecuador is affected by this illness. We describe CKD rates in Ecuador and hypothesize that CKD is impacted by temperature and the agricultural industry in Ecuador. Using publicly available data from the Instituto Nacional de Estadísticas y Censos from the years 2010—2015, we describe the rate of CKD among adults aged 20—45 in each province, as well as the agricultural industry across Ecuador. We combined this information with land surface temperature and used a Poisson mixed effects model to assess the relationship between mean temperature, maximum temperature and agricultural industry with CKD rates among adults aged 20—49 in each province. We found that the CKD rate is increasing in this age group over 2010—2015 (p=0.017), and in 2015, CKD rates were highest in Pastaza. Our spatial analysis found that both mean temperature and proportion of population in agriculture were positively associated with CKD rate by province in 2014 and 2015. This preliminary analysis shows that temperature and agricultural industry are associated with CKD rates among adults aged 20—49. While this association does not definitively show the presence of CKDu, it provides evidence to support further investigation of this illness in Ecuador. Un aumento de la enfermedad renal crónica (ERC) con una presentación atípica, ha afectado a muchos países tropicales. Esta enfermedad, conocida como enfermedad renal crónica de etiología desconocida (CKDu), se presenta en adultos más jóvenes sin las comorbilidades típicas de la ERC, entre los que trabajan en la producción agrícola. Se desconoce la causa de la enfermedad, pero se cree que la temperatura, el estrés por calor o la deshidratación contribuyen al desarrollo de esta afección. En Ecuador no hay información sobre si alguien está afectado por esta enfermedad. Describimos las tasas de ERC en Ecuador e hipotetizamos que la ERC se ve afectada por la temperatura y la industria agrícola en Ecuador. Utilizando datos disponibles públicamente del Institut