Mesoamerican nephropathy was initially described at the beginning of the current century in San Salvador, where an important group of young farmers presented with a clinic of chronic kidney disease of unknown etiology. Later this pathology was found in other countries on the Pacific coast and even on other continents outside of America. In all these countries, this sickness cause enormous health expenses, for example, the admission to chronic dialysis programs of patients, or simply the loss of work capacity.

At the IX Congress of the Paraguayan Society of Nephrology (2017), the nephrologist Guillermo Alvarez (Dominican Republic) presented an update on this condition, while the national nephrologist Dario Cuevas answered affirmatively to the following question: Is it possible to find Mesoamerican nephropathy in Paraguay?

After identifying a farmer in Itacurubí del Rosario with elevated serum creatinine and no data of systemic disease, high blood pressure or diabetes mellitus, a kidney biopsy is performed. The data obtained were published as a case report in one of the Journals of the International Society of Nephrology, Kidney Int Report, as the first case of this condition in Paraguay.

Chronic interstitial nephritis is a histological entity characterized by progressive scarring of the renal tubule interstitium, with tubular atrophy, infiltration of lymphocytes and macrophages, and interstitial fibrosis, and is studied by renal biopsy.

Mesoamerican nephropathy is characterized by elevated serum creatinine, non-nephrotic proteinuria in young men, without evidence of any risk factors for chronic kidney disease. No laboratory markers of this condition have been identified, so renal biopsy currently plays a central role in its evaluation and diagnosis.

Among other things, the identification of chronic interstitial nephritis in a community of farmers, leads us to important challenges to overcome: a. What is the prevalence of this condition among farmers in the country? B. What is the etiology of it? Also dehydration, heat, the use of pesticides and other chemicals, heavy metals could play an important role. Know precisely the etiology of the disease will lead to rational treatments, and know the prevalence and incidence will lead to defining public health policies on this disease.

Chronic dehydration and hypovolemia related to heat could play an important role in its appearance, although other researchers have achieved the use of toxic products during fumigation a central role in its genesis. In Paraguay, the results of a community monitoring of exposure to pesticides have been published with important data on the subject.

We believe that several research groups should be formed to study the impacts of this recently described disease in the country, in its different aspects