Those affected are mainly young men, as young as 17 years old, who conduct manual labor and farm work.

Officials at Costa Rica’s Social Security System (CCSS– Caja Costarricense de Seguro Social) have reported an alarming increase in potentially fatal chronic kidney disease cases in different parts of the country. Guanacaste is the most affected region.

In simple terms, chronic kidney disease is a condition in which kidney function is gradually lost over time. Once kidney failure occurs, the patient is unable to remove wastes and excess fluids from the blood, resulting in the need for dialysis. In this artificial process, a patient is connected to a machine that filters the blood. Generally most people who reach this stage are over 65 and have an underlying condition, such as diabetes or hypertension. However, this is not the case in this new group of Guanacaste patients.

The incidence of the disease in the area is so high that it has reached up to 113 per 100,000 people, nearly tripling the second region with the highest incidence, Cartago, with 43.8 per 100,000 people.

The outbreak in kidney failure is not limited to Costa Rica; many areas along the Pacific coast of Central America are also facing this terrible epidemic. Most cases occur in young men who conduct manual labor (mostly harvesting sugarcane, melon and cotton) and who work long hours under the sun and are constantly exposed to heat stress and pesticides.

As a result of this alarming situation, the CCSS is conducting a year-long study that began on August 16th. It will survey people from eight of the most affected cantons in Guanacaste: Cañas, Nandayure, Liberia, Bagaces, La Cruz, Nicoya, Hojancha and Carrillo. This study will seek to determine the cause of the disease and determine whether it is an occupational disease in order to implement urgent prevention and treatment strategies.

Possible factors that could be linked to the disease, and which researchers intend to rule out, are: pesticide and agrochemical exposure; consumption of home-brewed alcohol (known as guaro casero); overuse of pain medication and the region’s drinking water and soil conditions. But experts are pointing to the combination of prolonged exposure to high temperatures, dehydration and long work hours as the potential culprit of the disease and death among the area’s young men.

Many people with chronic kidney disease have no symptoms until they’ve reached advanced stages. When present, these are nonspecific symptoms such as: lack of appetite, headache, generally not feeling well, itching, nausea and weight loss. The only way of determining if you are experiencing this condition is through a lab test.

Stay alert! If you or someone you know may be part of the population at risk remember: always use adequate protective equipment when applying pesticides and chemicals, wash your hands after using these products, drink plenty of fluids during your work day, wear sun protection, take short breaks and, if you have any questions or doubts, consult your physician.

Written by Francisco Renick, MD for VoiceOfNosara.com.