title: Changes in kidney function among Nicaraguan sugarcane workers.
abstract: BACKGROUND
  There is an epidemic of chronic kidney disease (CKD) of unknown etiology in Central American workers.
  
  
  OBJECTIVE
  To investigate changes and job-specific differences in kidney function over a 6-month sugarcane harvest season, explore the potential role of hydration, and measure proteinuria.
  
  
  METHODS
  We recruited 284 Nicaraguan sugarcane workers performing seven distinct tasks. We measured urine albumin and serum creatinine and estimated glomerular filtration rate (eGFR).
  
  
  RESULTS
  eGFR varied by job and decreased during the harvest in seed cutters (-8·6 ml/min/1·73 m(2)), irrigators (-7·4 ml/min/1·73 m(2)), and cane cutters (-5·0 ml/min/1·73 m(2)), as compared to factory workers. The number of years employed at the company was negatively associated with eGFR. Fewer than 5% of workers had albumin-to-creatinine ratio (ACR) >30 mg/g.
  
  
  CONCLUSIONS
  The decline in kidney function during the harvest and the differences by job category and employment duration provide evidence that one or more risk factors of CKD are occupational.
authors: Rebecca L
authors: RL
authors: Laws
authors: Daniel R
authors: DR
authors: Brooks
authors: Juan José
authors: JJ
authors: Amador
authors: Daniel E
authors: DE
authors: Weiner
authors: James S
authors: JS
authors: Kaufman
authors: Oriana
authors: O
authors: Ramírez-Rubio
authors: Alejandro
authors: A
authors: Riefkohl
authors: Madeleine K
authors: MK
authors: Scammell
authors: Damaris
authors: D
authors: López-Pilarte
authors: José Marcel
authors: JM
authors: Sánchez
authors: Chirag R
authors: CR
authors: Parikh
authors: Michael D
authors: MD
authors: McClean
mesh_terms: D000293:Adolescent; D000328:Adult; D000419:Albuminuria; D003404:Creatinine / Q000097:blood; D000067565:Farmers; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D009527:Nicaragua / Q000453:epidemiology; D009784:Occupational Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D011507:Proteinuria / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000652:urine; D031786:Saccharum; D055815:Young Adult
chemical_list: D003404:Creatinine
keywords: Chronic kidney disease of nontraditional etiology,; Chronic kidney disease,; Estimated glomerular filtration rate,; Mesoamerican Nephropathy,; Serum creatinine,; Tubulointerstitial
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