The epidemic of chronic kidney disease in Central America

Immediate and coordinated action is needed to address the epidemic of chronic kidney disease sweeping across Central America. The disorder, known as CKDnT, is not related to traditional causes such as hypertension and diabetes, and mainly affects young male agricultural workers, the highest mortality being in El Salvador1 and Nicaragua (figure).2,3 However, CKDnT also affects women and non-agricultural workers living in farming communities. Mortality estimates from the Pan American Health Organization (PAHO) show that chronic kidney disease coded as N18 in WHO's International Classification of Diseases revision 10—a proxy for CKDnT—in men younger than 60 years has been responsible for thousands of deaths in the past decade in Central America.