The Scientific Report from the workshop is found here (193 pages)
MAIN MESSAGE FROM THE WORKSHOP
There is general scientific consensus based on multiple studies by different research groups in several countries that Mesoamerican Nephropathy has a predominantly occupational component. There is growing evidence for a causal role of strenuous work, heat and insufficient rehydration as risk factors in MeN, and progress has been made towards clarifying pathophysiological pathways for heat stress leading to chronic kidney disease. Intervention studies are warranted to reduce heat stress and dehydration in high risk workers.
It is also quite possible that other factors also play a role in the disease, perhaps in combination with heat stress and dehydration. Exposures to specific agrochemicals or other yet-unknown toxins need further evaluation as possible risk factors related to disease initiation or progression. The roles of infectious agents, NSAIDs, genetic susceptibility, gene-environment interactions and social determinants as contributors to disease onset and progression also need to be clarified.
Social and economic drivers of the disease, including working conditions, unemployment and precarious employment and poverty in general need to be analyzed both in community and workplace studies.
There is a need for standardized studies (including simple prevalence studies) to enable valid comparisons between countries and regions. This is an important step in ascertaining whether the epidemic of CKDu in Central America that we have called MeN is pathophysiologically similar to what is occurring in other parts of the world. Coordinated regional approaches to study prevalence, etiology, and to evaluate interventions are needed to find the causes of this disease and to seek viable solutions the challenges it presents.