Mesoamerican nephropathy is an occupational kidney disease seen in workers in Central America (meso = middle).
Occupations associated with the nephropathy:
(1) field workers, especially those who harvest sugar cane
(2) construction workers
Most patients are young males.
Manifestations:
(1) reduced eGFR
(2) increased serum creatinine and BUN
(3) proteinuria
(4) leukocyturia
(5) some combination of: fever, nausea/vomiting, back pain, muscle weakness, headache
The diagnosis involves exclusion of other causes of renal disease such as diabetes.
Possible explanations:
(1) heat stress with dehydration
(2) leptospirosis
(3) other infectious agent, possibly rodent borne
(4) hyperuricemia
