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Revista Colombiana de Nefrología

On-line version ISSN 2500-5006

Abstract

MUSSO, Carlos G. et al. Acute kidney injury in rural workers: An environmental-stress nephropathy. Rev. colom. nefrol. [online]. 2023, vol.10, n.3, 206.  Epub July 01, 2023. ISSN 2500-5006.  https://doi.org/10.22265/acnef.10.3.670.

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.

Keywords : Acute kidney injury; chronic interstitial nephritis of agricultural communities (CINAC); Mesoamerican nephropathy.

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