Acute kidney injury in rural workers: An environmental-stress nephropathy

Introduction: Mesoamerican nephropathy is a tubule-interstitial nephropathy whose etiology is still unknown. However, clinical cases like Mesoamerican nephropathy have been described in other geographically distant and ethnically diverse regions. Still, they all have a common factor: the intensity of heat and rural physical labor. Objective: To study whether this entity could occur among rural workers in a non-Mesoamerican region with similar climatic and working conditions, in the Colombian Caribbean countryside, and to consider how much repetitive dehydration could weigh in its pathogenesis. Methodology: An observational study was carried out, based on field work in a farm in Sitio Nuevo (Colombia) with 28 rural worker volunteers (rice fields), who were measured for weight, blood pressure, and blood and urine samples to measure electrolytes and osmolarity, at 2 times of the day (morning and evening). Results: Of the 28 young men workers evaluated, 5 (18 %) presented a significant increase in serum creatinine during the day (0.8±0.15 vs 1.2±0.17, p<0.001). The volume of water ingested by the workers was highly variable (2,861 ± 1,591 cc). There was a significant increase in serum sodium (p<0.001), and urinary osmolarity (p=0.01) values between morning and afternoon values in these 5 patients. Conclusions: Eighteen percent (18 %) of the workers evaluated developed parameters compatible with acute kidney injury and dehydration during the workday in the Colombian Caribbean countryside.

• Autores: Musso, Carlos G.; Aroca-Martínez, Gustavo; Avendaño-Echavez, Lil; Cadena-Bonfanti, Andrés; Castillo, Luis; González-Torres, Henry; Conde, Juan C.; Navarro-Quiroz, Elkin; Peña-Vargas, William; Hernandez, Sandra; Velez-Verbel, María de los Ángeles; Perez, Rafael; Sierra, Angélica; Rua, Zenen; Palmera, Jorge; Terrasa, Sergio
• Fecha de publicación: 2023
• Institución: Universidad Simón Bolívar
• Repositorio: Repositorio Digital USB
• Idioma: eng
• OAI Identifier: oai:bonga.unisimon.edu.co:20.500.12442/13428
• Acceso en línea: https://hdl.handle.net/20.500.12442/13428; http://doi.org/10.22265/acnef.10.3.670; https://revistanefrologia.org/index.php/rcn/article/view/670/1068
• Palabra clave: Acute kidney injury; Chronic interstitial nephritis of agricultural communities (CINAC); Mesoamerican nephropathy; Lesión renal aguda; Nefritis intersticial crónica de comunidades agrícolas (CINAC); Nefropatía mesoamericana
• Rights: openAccess
• License: Attribution-NonCommercial-NoDerivatives 4.0 Internacional