Physicians here zeroing in on chronic kidney disease

Doctors researching the abnormal rate of chronic kidney disease in Guanacaste gave a preliminary analysis of findings Wednesday. Physician Ray Wong, who works at the Caja Costarricense de Seguro Social in Libería, said the findings are consistent with their hypothesis that mostly uneducated men who work in physical labor are affected.

When Wong talked about the abnormal rate of chronic kidney disease persisting in Guanacaste, he compared the epidemic to a fixed lottery. As the medical team has randomly selected infected participants for the study, researchers continue to find that none is from a professional, well-educated background.

“The lottery is balanced to the low education level,” Wong said.

He confirmed that 75 percent of those inflicted are men.

Although Wong said the preliminary data is not enough to make a conclusion about the effects of dehydration, he did comment that his team is studying how much water the ailing parties drink. They are also looking into alcohol consumption, namely the cheap bootleg alcohol popular in Guanacaste.

“This low-quality alcohol that they drink gives them a very low hydration rate,” Wong said. “It makes it almost the same as if they had drank zero liquids.”

Though the final results will not be fully known until later this year, researchers already have half of their overall data sample collected from 850 participants.

In six weeks research will be finalized in Liberia and other cantons, where Wong and five others have been working to pinpoint a central cause for the disease.
Studies have yet to start in Santa Cruz but should be concluded there by June. After each field review there is a two-month grace period for data analysis, said Wong.

Researchers have divided their field work into three sections that allow them to make correlations between an ailing person and his or her history leading up to kidney issues. The first step is to confirm whether a person suffers from the specific kidney condition. Initial hospital tests are done and data is collected from the patients. Then doctors wait three months before giving the patients another blood test to confirm if the person has chronic kidney disease.

Doctors conduct 30-minute interviews with patients grouped in each of the eight cantons. They classify them according to age, gender, profession, and other demographic details. Lastly, they compare the ill with healthy volunteers. The goal is rule out and emphasize competing factors. The main point of the study is to find what factors created or augmented the health problem.

The expensive field studies used to be harder because unaffected people weren’t lining up to take part in the control group. Now, Wong said, the information made public by media outlets and administrative heads has made residents of Guanacaste aware that their neighbors are facing a serious issue.

“These healthy volunteers are worried about their community,” he said. “Today its easier because community leaders have also motivated the healthy people to participate in the studies”

Response rate is up to 85 percent for the control groups, which consist of 25 subjects from each canton. The Guanacaste cantons under review are La Cruz, Nicoya, Nandayure, Cañas, Libería, Carrillo, Bagaces, and Santa Cruz.

The study is one of a number taking place in Central America where there is an unusually high rate of kidney disease among residents who are mostly sugar cane workers.

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