Changes in kidney function among Nicaraguan sugarcane workers

Abstract

Background:

There is an epidemic of chronic kidney disease (CKD) of unknown etiology in Central American workers.

Objectives:

To investigate changes and job-specific differences in kidney function over a 6-month sugarcane harvest season, explore the potential role of hydration, and measure proteinuria.

Methods:

We recruited 284 Nicaraguan sugarcane workers performing seven distinct tasks. We measured urine albumin and serum creatinine and estimated glomerular filtration rate (eGFR).

Results:

eGFR varied by job and decreased during the harvest in seed cutters (−8·6 ml/min/1·73 m²), irrigators (−7·4 ml/min/1·73 m²), and cane cutters (−5·0 ml/min/1·73 m²), as compared to factory workers. The number of years employed at the company was negatively associated with eGFR. Fewer than 5% of workers had albumin-to-creatinine ratio (ACR) >30 mg/g.

Conclusions:

The decline in kidney function during the harvest and the differences by job category and employment duration provide evidence that one or more risk factors of CKD are occupational.

Keywords:

• Chronic kidney disease
• Mesoamerican Nephropathy
• Chronic kidney disease of nontraditional etiology
• Estimated glomerular filtration rate
• Serum creatinine
• Tubulointerstitial