Leptospira seropositivity as a risk factor for Mesoamerican Nephropathy.
BACKGROUND
Leptospirosis is postulated as a possible cause of Mesoamerican Nephropathy (MeN) in Central American workers.


OBJECTIVES
Investigate job-specific Leptospira seroprevalence and its association with kidney disease biomarkers.


METHODS
In 282 sugarcane workers, 47 sugarcane applicants and 160 workers in other industries, we measured anti-leptospiral antibodies, serum creatinine, and urinary injury biomarkers, including neutrophil gelatinase-associated lipocalin (NGAL), interleukin-18 (IL-18), and N-acetyl-D-glucosaminidase (NAG).


RESULTS
Leptospira seroprevalence differed among job categories and was highest among sugarcane cutters (59%). Seropositive sugarcane workers had higher NGAL concentrations (relative mean: 1.28; 95% CI: 0.94-1.75) compared to those who were seronegative, with similar findings among field and non-field workers.


CONCLUSIONS
Leptospira seroprevalence varied by job category. There was some indication that seropositivity was associated with elevated biomarker levels, but results were inconsistent. Additional studies may help establish whether Leptospira infection plays any role in MeN among Central American workers.
['Riefkohl|Alejandro|A|0000-0002-1948-9219', 'Ramírez-Rubio|Oriana|O|', 'Laws|Rebecca L|RL|0000-0001-8249-5999', 'McClean|Michael D|MD|', 'Weiner|Daniel E|DE|0000-0002-8775-394X', 'Kaufman|James S|JS|0000-0002-6778-4167', 'Galloway|Renee L|RL|', 'Shadomy|Sean V|SV|0000-0001-7446-5263', 'Guerra|Marta|M|', 'Amador|Juan José|JJ|', 'Sánchez|José Marcel|JM|', 'López-Pilarte|Damaris|D|', 'Parikh|Chirag R|CR|', 'Leibler|Jessica H|JH|', 'Brooks|Daniel R|DR|']
D000328:Adult D000907:Antibodies, Bacterial D015415:Biomarkers D003404:Creatinine D000067565:Farmers D005260:Female D006801:Humans D020382:Interleukin-18 D007919:Leptospira D007922:Leptospirosis D000071068:Lipocalin-2 D008297:Male D008875:Middle Aged D009527:Nicaragua D011446:Prospective Studies D051436:Renal Insufficiency, Chronic D016036:Seroepidemiologic Studies D055815:Young Adult
Leptospira Mesoamerican Nephropathy (MeN) Neutrophil gelatinase-associated lipocalin (NGAL) Interleukin-18 (IL-18) Chronic kidney disease (CKD) Chronic kidney disease of nontraditional etiology (CKDnt) Ieptospirosis N-acetyl-D- glucosaminidase (NAG)