Table 1.

Clinical features associated with endemic Central American CKD

Epidemiology of CKD
 Men more commonly affected
 Common in third to fifth decade of life
 Not associated with diabetes or obesity
 More common at lower altitudes
Uncertain association
 High local prevalence of lower urinary tract symptoms among men (chistata) often accompanied by pyuria and positive leukocyte esterase
Kidney and urinary tract manifestations
 Minimal to moderate proteinuria
 Indolent and slowly progressive
 Ultrasound shows small echogenic kidneys
 A very limited number of biopsies performed in individuals with advanced disease shows fibrosis
 When present, urinary symptoms with pyuria and leukocyte esterase positivity are accompanied by negative urine culture (3)