Volume 31, Issue 3, March 2016

Until recently, the WHO consensus statement on non-communicable diseases (NCD) included cardiovascular disease, cancer, diabetes and chronic respiratory disease, but not kidney disease. Fortunately, the Political Declaration on NCDs from the United Nations Summit in 2011 mentioned kidney disease under Item 19.35.

Zdrojewski et al. present a survey assessing the prevalence of albuminuria and renal dysfunction in a representative sample of the adult Polish population. This survey documents that the prevalence of CKD in this country (5.8% by CKD-EPI and 6.2% by MDRD) is the lowest registered in economically developed countries. On the other hand, a survey in a well-characterized sample of elderly people from the AGES-Rejkjavik cohort shows that in this country as many as 10 elderly individuals out of 25 have a reduced GFR (<60/ml/min/1.73m2) and that 10 out of 22 have a reduced GFR or albuminuria. Of note, in this survey, the prevalence of hyperparathyroidism, anaemia, hypoalbuminaemia and acidosis–all typical complications of CKD–is substantially higher among subjects with CKD as compared to those without, supporting the view that CKD in the elderly should not be seen as an innocent alteration.

Several epidemiological studies have described an excess of CKD among younger adult males in the geographic region, which includes Southeastern Mexico, Guatemala, Belize, El Salvador, Honduras, Nicaragua, Costa Rica, and Panama. This condition is now known as Mesoamerican nephropathy (MeN). Ramírez-Rubio et al. evaluated whether a greater prevalence of kidney damage might be present even in Nicaraguan children. The results of this study suggest the possibility of early kidney damage in adolescents from this region, prior to occupational exposures.