Lopez AAV, Barahona K and Guerra EHC
Endemic nephropathy disease unexplained by diabetes or hypertension is highly prevalent on countries of Latin America. The purpose of this review is to present a brief summary to analyze de epidemiologic data on morbidity and mortality as well as the etiology unexplained by diabetes and hypertension, with emphasis in studies from areas of sugarcane, heat stress or cotton plantation, to understand the contributing social and work factors. From our review we conclude that clinical trials are needed to elucidate the nephropathy unexplained by conventional risk factors in Guatemala, Honduras, Panama, and Mexico, and some other countries, from areas of sugarcane, heat stress or cotton plantation work. Regular monitoring assessment of heat stress during harvesting season needs to be implemented by labor ministries authorities in a way to regulate the compliance of each employer on measures they should take to prevent worker illnesses and death caused by heat stress. Although there is some evidence about hydration preventing nephropathy, large clinical trials are needed to determine the extent of supplemental hydration solutions and time interval to slow the loss of kidney function in areas of sugarcane, heat stress or cotton plantation work. Employers should take steps that help workers become acclimatized, gradually build up exposure to heat, especially workers who are new to working in the heat or have been away from work.