A Case Control Study of Mesoamerican Nephropathy in Farmers with Long-Term Exposure to Agrochemical Compounds in El Salvador

Introduction: Chronic kidney diseases (CKD) are very prevalent in Central America, particularly in El Salvador. Mesoamerican nephropathy (MN) is a CKD diagnosis that mostly affects male agricultural labourers; its aetiology is debatable. Prolonged contact with plague control pesticides is among the possible causes. To determine if there is any association between farming and long-term exposure to such chemical substances and MN in male agricultural labourers, a case control study was performed. Methods: From January 2020–December 2021, the authors gathered a group of 143 male patients with CKD who met the MN criteria, as well as 572 male matched controls with no kidney disease. All were asked about any long-term exposure to agrochemical pesticides, and the odds ratio was calculated. Results: A total of 715 individuals were included. There were 127 cases of MN in individuals who were exposed to agrochemicals and 16 cases in the non-exposed patients. Among the controls, the authors found that 348 had been exposed, while 224 had not. Exposure to pesticides was 5.2 times more likely to be associated with MN compared with individuals with no kidney disease. Conclusion: MN could be a multifactorial disease, where heat stress and dehydration combine with direct long-term exposure to pesticides, causing damage to kidneys’ tubular network and leading to CKD. Further research is needed.