Objective: Identify early biomarkers and mechanisms of acute kidney injury in workers at risk of developing chronic kidney disease of unknown origin (CKDu). Methods: We assessed cross-shift changes in kidney function and biomarkers of injury in 105 healthy sugarcane workers. We obtained pre-harvest clinical data as well as daily environmental, clinical, and productivity data for each worker. Results: The average percent decline in cross-shift estimated glomerular filtration rate (eGFR) was 21.8% (standard deviation [SD] 13.6%). Increasing wet bulb globe temperature (WBGT), high uric acid, decreased urine pH, urinary leukocyte esterase, and serum hyperosmolality were risk factors for decline in kidney function. Conclusions: Sugarcane workers with normal kidney function experience recurrent subclinical kidney injury, associated with elevations in biomarkers of injury that suggest exposure to high temperatures and extreme physical demands.
1.Ctr Hlth Work & Environm, Boulder, CO USA 2.Univ Colorado, Dept Emergency Med, Sch Med, Boulder, CO USA 3.Colorado Consortium Climate Change & Human Hlth, Boulder, CO USA 4.Dept Environm & Occupat Hlth, Boulder, CO USA 5.Colorado Sch Publ Hlth, Boulder, CO USA 6.Colorado Sch Publ Hlth, Div Renal Dis & Hypertens, Pantaleon, Guatemala 7.Univ Colorado, Div Pulm Sci & Crit Care Med, Dept Med, Sch Med, Aurora, CO USA
Recommended Citation:
Sorensen, Cecilia J.,Butler-Dawson, Jaime,Dally, Miranda,et al. Risk Factors and Mechanisms Underlying Cross-Shift Decline in Kidney Function in Guatemalan Sugarcane Workers[J]. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE,2019-01-01,61(3):239-250