caregivers, policy makers, researchers, and clinicians, the network promotes a cultural shift from care which is disease-centered and provider-focused to care which is patient-centered, informed by evidence, and coordinated across the health care system. By focusing on the patient’s voice and implementing relevant findings in real time, Can-SOLVE CKD will transform the care that CKD patients receive, and will improve kidney health for future generations. Ethics Approval and Consent to Participate No ethics approval or consent to participate was required for this publication. Consent for Publication All authors read and approved the final version of this manuscript. Availability of Data and Materials No primary data is presented in this publication. Acknowledgment The authors thank all patients, researchers, policy makers, health care professionals, and other partners who inspire and support this network. Declaration of Conflicting Interests The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work is supported by the Canadian Institutes of Health Research through the Strategy for Patient-Oriented Research (SPOR). Additional funding is provided by more than 30 partners, including provincial kidney care agencies, universities, industry, and private donors. References 1. Manns BJ, Mendelssohn DC, Taub KJ. The economics of endstage renal disease care in Canada: incentives and impact on delivery of care. Int J Health Care Finance Econ. 2007;7(2- 3):149-169. 2. Coca SG, Krumholz HM, Garg AX, Parikh CR. Underrepresentation of renal disease in randomized controlled trials of cardiovascular disease. JAMA. 2006;296(11):1377-1384. 3. Jun M, Manns B, Laupacis A, et al. Assessing the extent to which current clinical research is consistent with patient priorities: a scoping review using a case study in patients on or nearing dialysis. Can J Kidney Health Dis. 2015;2:35. 4. INVOLVE. http://www.invo.org.uk/. Accessed December 7, 2017. 5. Patient-Centered Outcomes Research Institute. http://www. pcori.org/. Accessed December 7, 2017. 6. Tong A, Chando S, Crowe S, et al. Research priority setting in kidney disease: a systematic review. Am J Kidney Dis. 2015;65(5):674-683. 7. Strategy for Patient-Oriented Research. http://www.cihr-irsc. gc.ca/e/41204.html. Accessed December 7, 2017. 8. Harnett J, Barrett B, Belanger P, et al. Horizons 2015: Enhancing Excellence and Capacity in Kidney Research Consultation Report. 2007. 9. Hemmelgarn BR, Pannu N, Ahmed SB, et al. Determining the research priorities for patients with chronic kidney disease not on dialysis. Nephrol Dial Transplant. 2017;32:847-854. 10. Burns KD, Wolfs W, Bélanger P, McLaughlin K, Levin A. The KRESCENT Program: an initiative to match supply and demand for kidney research in Canada. Clin Invest Med. 2010;33(6):E356-E367. 11 Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies Suggested citation Lozier M, Turcios-Ruiz RM, Noonan G, Ordunez P. Chronic kidney disease of nontraditional etiology in Central America: a provisional epidemiologic case definition for surveillance and epidemiologic studies. Rev Panam Salud Publica. 2016;(40)5:294-300. 1 Epidemic Intelligence Service, Centers for Disease Control and Prevention, National Center for Environmental Health, Air Pollution and Respiratory Health Branch, Atlanta, Georgia, United States of America. Send correspondence to: Matthew Lozier, mlozier@cdc.gov 2 Centers for Disease Control and Prevention, Center for Global Health, Division of Global Health Protection, Central American Regional Office, Guatemala City, Guatemala. 3 Centers for Disease Control and Prevention, National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Atlanta, Georgia, United States of America. 4 Pan American Health Organization/World Health Organization, Noncommunicable Diseases Unit, Washington, D.C., United States of America. INTRODUCTION Chronic kidney disease (CKD) is a condition that affects populations of developed and developing countries alike. In most parts of the world, CKD is associated with older age and such chronic conditions as diabetes (regardless of the type), hypertension, and cardiovascular disease (1). However, along the Pacific coast of Mesoamerica from southern Mexico to Costa Rica (especially in El Salvador and Nicaragua), high prevalence of CKD not associated with the most commonly reported etiologies worldwide has been identified in certain agricultural communities, predominantly among male farmworkers (2-4). Experts have estimated that this disease has caused premature deaths of at least 20 000 men (5). National CKD mortality rates among males show excess mortality in Nicaragua and El Salvador (66 and 64 per 100 000, respectively), compared to Guatemala (16 per 100 000), Panama (15 per 100 000), Costa Rica (8 per 100 000), and the United States of America (4 per 100 000) (6). In addition, CKD mortality rates are higher among men than among women (e.g., in Nicaragua, 66 vs. 21 per 100 000,