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

• Main Authors: Carlos G. Musso (Author), Gustavo Aroca-Martínez (Author), Lil Avendaño-Echavez (Author), Andrés Cadena-Bonfanti (Author), Luis Castillo (Author), Henry González-Torres (Author), Juan C Conde (Author), Elkin Navarro-Quiroz (Author), William Peña-Vargas (Author), Sandra Hernandez (Author), María de los Ángeles Velez-Verbel (Author), Rafael Perez (Author), Angélica Sierra (Author), Zenen Rua (Author), Jorge Palmera (Author), Sergio Terrasa (Author)
• Format: Book
• Published: Asociación Colombiana de Nefrología e Hipertensión Arterial, 2023-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2500-5006; 10.22265/acnef.10.3.670
• Keywords: acute kidney injury; mesoamerican nephropathy; chronic interstitial nephritis of agricultural communities (cinac); Internal medicine; RC31-1245; Diseases of the genitourinary system. Urology; RC870-923
• Source: Revista Colombiana de Nefrología, Vol 10, Iss 3 (2023)

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.