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Environ Res. 2016 May;147:125-32. doi: 10.1016/j.envres.2016.02.002. Epub 2016 Feb 8.

Kidney function in sugarcane cutters in Nicaragua--A longitudinal study of workers at risk of Mesoamerican nephropathy.

Author information

1
Unit of Occupational Medicine, Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden. Electronic address: inekewesseling@gmail.com.
2
Research Center on Health, Work and Environment (CISTA), Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua. Electronic address: auroraragon@gmail.com.
3
Research Center on Health, Work and Environment (CISTA), Autonomous University of Nicaragua at León (UNAN-León), León, Nicaragua; Department of Non-communicable Disease Epidemiology of London School of Hygiene and Tropical Medicine, London, UK. Electronic address: marvin99_00@yahoo.es.
4
La Isla Foundation, Chicago, IL, USA. Electronic address: ilana@laislafoundation.org.
5
La Isla Foundation, Chicago, IL, USA. Electronic address: jason@laislafoundation.org.
6
Department Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico; Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico City, Mexico. Electronic address: nab@biomedicas.unam.mx.
7
Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO, USA. Electronic address: tamara.harra@ucdenver.edu.
8
Department Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición, Salvador Zubirán, Mexico City, Mexico. Electronic address: correarotter@gmail.com.
9
Division of Renal Diseases and Hypertension, University of Colorado, Aurora, CO, USA. Electronic address: Richard.Johnson@ucdenver.edu.
10
Occupational and Environmental Medicine, Sahlgrenska University Hospital and University of Gothenburg, Sweden. Electronic address: lars.barregard@amm.gu.se.

Abstract

BACKGROUND:

Chronic kidney disease is common among sugarcane workers in Central America. The main risk factor seems to be repeated high-intensity work in hot environments. Several cross-sectional studies have been performed but few longitudinal studies.

OBJECTIVES:

The aim of the study was to examine whether kidney function changes over a few months of work during the harvest period.

METHODS:

A group of male sugarcane cutters in Nicaragua (N=29, aged 17-38 years) was examined with renal biomarkers before and after shift on the first day at the start of harvest, on the sixth day during acclimatization, and then in mid-harvest 9 weeks later. A reference group (N=25, mainly office workers) was examined with the same biomarkers at start of harvest, and then at end of harvest 5 months later.

RESULTS:

The pre-shift renal function decreased significantly during 9 weeks of work in the cane cutters. Mean serum creatinine increased (20%), mean estimated glomerular filtration rate decreased (9%, 10mL/min), serum urea N (BUN) increased (41%), and mean urinary neutrophil gelatinase-associated lipocalin (NGAL) increased (four times). The cane cutters also developed cross-shift increases in these biomarkers, in particular serum creatinine and BUN, and in urinary uric acid. The longitudinal decrease in eGFR tended to be associated with the cross-shift increase in serum creatinine.

CONCLUSIONS:

There was a remarkable decrease of glomerular kidney function, after only 9 weeks of harvest. The cross-shift increase in serum creatinine may be caused by dehydration (pre-renal dysfunction), and when repeated on a daily basis this may cause permanently reduced GFR.

KEYWORDS:

BUN; Chronic kidney disease; Heat stress; Hsp72; KIM-1; NGAL; Occupational; eGFR

PMID:
26866450
DOI:
10.1016/j.envres.2016.02.002
[Indexed for MEDLINE]

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