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标题：La epidemia de enfermedad renal crónica en El Salvador: la influencia de los agroquímicos
其他标题：La epidemia de enfermedad renal crónica en El Salvador: la influencia de los agroquímicos
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作者：Orantes Navarro, Carlos Manuel ; Almaguer López, Miguel ; Alonso Galbán, Patricia 等
期刊名称：Revista Cubana de Medicina Tropical
印刷版ISSN：0375-0760
电子版ISSN：1561-3054
出版年度：2020
卷号：72
期号：2
页码：1
出版社：1999, Editorial Ciencias Médicas
摘要：Introduction: An epidemic of chronic kidney disease (CKD) of devastating consequences has been taking place in El Salvador over the last few decades. In a significant portion of affected subjects, no other common cause of chronic kidney disease is present, such as diabetes and hypertension. This illness is usually called Chronic Kidney Disease from Non-Traditional Causes (CKDnT). Previous studies have shown a high prevalence of exposure to agrochemicals in affected populations, particularly in rural areas. In addition to sustained exposure to agrochemicals, the other leading hypothesis to explain this epidemic is prolonged exposure to high temperatures and dehydration in a context of exhausting agricultural work. Objectives: To assess the possible causal effect of exposure to agrochemicals in the emergence of the CKD epidemic in the adult population of El Salvador. Methods: We conducted a case-control analysis based on the 2015 survey of Chronic Diseases in Adults in El Salvador, a national probabilistic sample that covered 4,817 adults ≥20 years old. Those suffering from CKD were considered cases; the rest were managed as controls. Self-reported agrochemical exposures, other risk factors and health conditions were recorded. For binary exposures, the odds ratio (OR) of CKD and CKDnT was estimated. For variables measuring length of exposure, the average values for cases and for controls were compared. In all cases, the corresponding 95% confidence intervals were calculated. Multivariate logistic regression was used to examine the association between exposure to agrochemicals and CKD while controlling for potential confounding variables. Results: Regardless of how past exposure to agrochemicals was characterized (e.g., contact with paraquat or aerial fumigation) the OR of both CKD and CKDnT was always greater than 1.0 (range, 1.36 to 3.75). Similarly, the average number of years of exposure was consistently higher for cases than for controls for all continuous variables examined (greater than 2 years in most cases). Conclusions: The results of this study are consistent with previous epidemiologic and toxicological evidence and support the hypothesis that exposure to agrochemicals may be causally implicated in the ongoing CKD epidemics in El Salvador.
关键词：enfermedad renal crónica;agroquímicos;epidemia;El Salvador;estudio de casos y controles;ERCnT;ERCu
其他关键词：Chronic kidney disease;agrochemicals;epidemic;El Salvador;case-control study;CKDnT;CKDu