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

Acute kidney injury
Mesoamerican nephropathy
Chronic interstitial nephritis of agricultural communities (CINAC)

How to Cite

1.
Musso CG, Aroca-Martínez G, Avendaño-Echavez L, Cadena-Bonfanti A, Castillo L, González-Torres H, Conde JC, Navarro-Quiroz E, Peña-Vargas W, Hernandez S, Velez-Verbel M de los Ángeles, Perez R, Sierra A, Rua Z, Palmera J, Terrasa S. Acute kidney injury in rural workers: An environmental-stress nephropathy. Rev. Colomb. Nefrol. [Internet]. 2023 Nov. 15 [cited 2024 Feb. 26];10(3). Available from: https://revistanefrologia.org/index.php/rcn/article/view/670

Abstract

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.

https://doi.org/10.22265/acnef.10.3.670
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