Enfermedad renal crónica de causas desconocidas en Mesoamérica. Análisis desde la perspectiva de la medicina geológica.

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Bibliographic Details
Title:	Enfermedad renal crónica de causas desconocidas en Mesoamérica. Análisis desde la perspectiva de la medicina geológica.
Alternate Title:	Chronic Kidney Disease of Unknown Causes in Mesoamerica. An Approach from the Perspective of Medical Geology.
Authors:	Montero-Campos, Virginia¹ vmontero@itcr.ac.cr, Estrada-Zeledón, Javier A.², Blanco-Castro, Diego³
Source:	Nefrologia. Jun/Jul2026, Vol. 46 Issue 6, p1-8. 8p.
Subjects:	HEAVY metals, SANDY soils, MEDICAL geography, CHRONIC kidney failure, ENVIRONMENTAL risk, EPIDEMIOLOGY, PHYSIOGRAPHIC provinces, NEPHROTOXICOLOGY
Geographic Terms:	MESOAMERICAN region
Abstract (English):	In Mesoamerica, new cases of chronic kidney disease of unknown cause (CKDu) are increasing each year, including those requiring renal replacement therapy and deaths from this cause. It tends to manifest in younger people, who present symptoms late, in stages 4 and 5. Geographically, cases occur in specific well- recognized areas of Mesoamerica: low-lying areas associated with the Pacific coast, warm and dry regions with high wind traffic, volcanic activity and sandy soils. This comprehensive review was conducted without the use of generative AI (artificial intelligence) to provide novel criteria regarding potential environmental and epidemiological risk factors currently recognized in the global scientific literature. The factors investigated were approached from the novel perspective of medical geology, which addresses the risk to populations affected by different environmental variables specific to their living environment, presenting a similar risk under the same exposure scenario. According to the literature found related to CKDu, it is suggested that nephrotoxic heavy metals in medium and low doses present in sandy soils, typical of the specific areas of high prevalence of the disease in Mesoamerica, India and Sri Lanka contribute with genotoxic and epigenetic damage from various perspectives as common causal agents, which were quantified in some sites of prevalence of the disease. [ABSTRACT FROM AUTHOR]
Abstract (Spanish):	En Mesoamérica, los nuevos casos de enfermedad renal crónica de causas desconocidas (ERCcd) aumentan cada año, incluyendo las personas que necesitan terapia renal sustitutiva y las muertes por esta causa, con tendencia a manifestarse en personas de menor edad que presentan sintomatología de manera tardía en estados 4 y 5. Desde el punto de vista geográfico, los casos se presentan en zonas puntuales ya reconocidas de Mesoamérica, los cuales son lugares de baja altura asociados a la costa pacífica, zonas cálidas y secas, de alto tráfico de viento, asociadas a volcanes y de suelos de tipo arenoso. La presente revisión se realizó de forma exhaustiva, sin uso de IA (inteligencia artificial) generativa, con el objetivo de proporcionar criterios novedosos, sobre posibles factores de riesgo ambientales y epidemiológicos actualmente reconocidos en la literatura científica mundial. Los factores investigados fueron abordados desde la novedosa perspectiva de la medicina geológica, la cual se refiere al abordaje del riesgo de las poblaciones afectadas por diferentes variables ambientales propias del entorno donde viven, presentándose bajo un mismo riesgo en un escenario de exposición. De acuerdo con la literatura encontrada relacionada con ERCcd, se sugiere que metales pesados de naturaleza nefrotóxica en dosis medias y bajas presentes en los suelos arenosos, propios de las zonas específicas de alta prevalencia de la enfermedad en Mesoamérica, India y Sri Lanka, contribuyen con daño genotóxico y epigenético desde diversas perspectivas como agentes causales comunes, los cuales fueron cuantificados en algunos sitios de prevalencia de la enfermedad. [ABSTRACT FROM AUTHOR]
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Database:	MedicLatina

Description
Abstract:	In Mesoamerica, new cases of chronic kidney disease of unknown cause (CKDu) are increasing each year, including those requiring renal replacement therapy and deaths from this cause. It tends to manifest in younger people, who present symptoms late, in stages 4 and 5. Geographically, cases occur in specific well- recognized areas of Mesoamerica: low-lying areas associated with the Pacific coast, warm and dry regions with high wind traffic, volcanic activity and sandy soils. This comprehensive review was conducted without the use of generative AI (artificial intelligence) to provide novel criteria regarding potential environmental and epidemiological risk factors currently recognized in the global scientific literature. The factors investigated were approached from the novel perspective of medical geology, which addresses the risk to populations affected by different environmental variables specific to their living environment, presenting a similar risk under the same exposure scenario. According to the literature found related to CKDu, it is suggested that nephrotoxic heavy metals in medium and low doses present in sandy soils, typical of the specific areas of high prevalence of the disease in Mesoamerica, India and Sri Lanka contribute with genotoxic and epigenetic damage from various perspectives as common causal agents, which were quantified in some sites of prevalence of the disease. [ABSTRACT FROM AUTHOR]
ISSN:	02116995
DOI:	10.1016/j.nefro.2026.501533