Leptospira seropositivity as a risk factor for Mesoamerican Nephropathy

Alejandro Riefkohl, Oriana Ramírez-Rubio, Rebecca L. Laws, Michael D. McClean, Daniel E. Weiner, James S. Kaufman, Renee L. Galloway, Sean V. Shadomy, Marta Guerra, Juan José Amador, José Marcel Sánchez, Damaris López-Pilarte, Chirag R. Parikh, Jessica H. Leibler, Daniel R. Brooks

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalInternational Journal of Occupational and Environmental Health
Issue number1
StatePublished - Jan 2 2017
Externally publishedYes


  • Chronic kidney disease (CKD)
  • Chronic kidney disease of nontraditional etiology (CKDnt)
  • Ieptospirosis
  • Interleukin-18 (IL-18)
  • Leptospira
  • Mesoamerican Nephropathy (MeN)
  • N-acetyl-D- glucosaminidase (NAG)
  • Neutrophil gelatinase-associated lipocalin (NGAL)

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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