#NephJC this Tuesday, we dive into MesoAmerican Nephropathy

Readers of PBFluids know that I have been on the uric acid is the source of hypertension and hypertensive nephropathy beat ever since Richard Johnson came to the Townsend to speak at a gout symposium. Johnson’s lecture on the link between uric acid and hypertension is the single best lecture I have ever seen.

Before that lecture I thought I was a pretty good lecturer, that lecture taught me that I was a baby. I knew nothing. If you ever get a chance to hear Dr. Johnson, move heaven and earth to hear him, he is amazing.

You can see some of my posts relating to uric acid, fructose and kidney disease here:

DreamRCT submission: Prove the uric acid-CKD connection
My hour long presentation on the subject for the Michigan ACP
Use of Mendelian Randomization to determine the effect of uric acid on blood pressure
Summary of the introduction to The Sugar Fix, Richard Johnson’s diet book
My summary of the Goicoechea data showing the protective effect of allopurinol in CKD
Editorial I wrote about obesity, fructose and uric acid.

Though not covered extensively on PBFluids one of the most interesting stories in nephrology for the last year has been the emergence of a newly recognized epidemic of renal disease in Central America. I first learned about it following this tweet:

.@pbjpaulito Did you know about this? http://t.co/ttcnT21GCzcc @kidney_boy
— Meenakshi Budhraja (@gastromom) June 29, 2013

and I was recently reminded about this when this tweet crossed my stream:

“@Amazing_Maps: The disease most likely to kill you Source: http://t.co/8tqGkI3KRv– pic.twitter.com/IFswcuu3Fb” Kidneys in Central America
— Joel Topf (@kidney_boy) June 24, 2014

Here is a close up of the only country in the world where Nephritis and nephrosis is the leading cause of death, Nicaragua.

The one time I blogged about this. Though I haven’t been fastidious about the MesoAmerican Nephropathy beat, eAJKD has:

MesoAmerican Nephropathy: A New Entity. Biopsy results from the endemic area.
Three Epidemics Across 10,000 Miles: Can We Connect the Dots? Editorial on the disease, focusing on the possibility of pesticides as the etiologic agent.

Interestingly, these two intrigues subjects, the toxicity of uric acid/fructose and MesoAmerican Nephropathy collided in a recent editorial by Richard Johnson et. al. This editorial is the subject of this week’s NephJC on Tuesday, July 8th at 9:00 Eastern.

The article is a perspective review titled: Hyperosmolarity drives hypertension and CKD-water and salt revisited. (PMID: 24802066)

I was told that Nature Reviews Nephrology was going to make the article open access and it was a few weeks ago but for now it is closed. Make nice to your local medical librarian.

More background and a summary of the article tomorrow.

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