Chronic Kidney Disease Among Workers: A Review of the Literature

Abstract

For the past two decades, agricultural workers in regions of Central America have reported an epidemic of chronic kidney disease of undetermined etiology (CKDu) that is not associated with established risk factors of chronic kidney disease. Several hypotheses have emerged, but the etiology of CKDu remains elusive and controversial. The aim of this literature review was to describe the potential risk factors of CKDu in Mesoamerica and implications for the U.S. agricultural worker population. PubMed and CINAHL databases were searched for articles published between 2000 and 2018 that examined CKDu in Mesoamerica; 29 original studies were included in this review. CKDu is a multifactorial disease that is often asymptomatic with hallmark characteristics of elevated serum creatinine and blood urea nitrogen (BUN), low glomerular filtration rate, electrolyte abnormalities, and non-nephrotic proteinuria. Reducing the global prevalence of CKDu will require more robust studies on causal mechanisms and on interventions that can reduce morbidity and mortality in vulnerable populations.

Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress

“…Prevalence studies have added information about occupations at risk for CKDnt, both agricultural and non-agricultural. While it is often stated that young, male agricultural workers are disproportionally affected by CKDnt (18,19,23,24,26,27), not all types of agricultural workers are affected equally, and some non-agricultural occupations also carry increased risks. In agriculture, the highest risk for CKDnt is for sugarcane cutters and field workers (17,20,22,28) with CKDnt also reported for cotton, banana, rice and corn workers (17,19,20,23,29).…”

Occupational Heat Exposure as a Risk Factor for End-Stage Kidney Disease

“…Finally, the only socioeconomic aspect assessed in our study was the level of education. The results did not show a relation between the level of education and ESKD, although several studies have shown that people with low levels of education are at risk of developing kidney failure 15,25 . The relation between education and kidney problems is complex, but appears to be behavioral.…”

“…The results did not show a relation between the level of education and ESKD, although several studies have shown that people with low levels of education are at risk of developing kidney failure. 15,25 The relation between education and kidney problems is complex, but appears to be behavioral. People with lower levels of education are more likely to be smokers and alcoholics, less physically active, and unaware of disease detection and prevention.…”

Workers’ Perception Heat Stress: Results from a Pilot Study Conducted in Italy during the COVID-19 Pandemic in 2020

“…Heatstroke is a potentially life-threatening health condition that is facilitated by carrying out strenuous activities in severe heat and/or humidity [16]. Kidney diseases are also often diagnosed in otherwise healthy young adults commonly exposed to heat and dehydration in the workplace [17,18].…”