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Point-of-care bioma...
Point-of-care biomarkers for prediction of kidney function trajectory among sugarcane cutters: a comparative test accuracy study
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- Hansson, Erik, 1987 (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Sahlgrenska Academy,La Isla Network
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- Wesseling, C. (author)
- Karolinska Institute,La Isla Network
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- Wegman, D. (author)
- La Isla Network,University of Massachusetts Lowell
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- Ekström, Ulf (author)
- Lund University,Lunds universitet,Proteasinhibitorforskning,Forskargrupper vid Lunds universitet,Protease Inhibitor Research,Lund University Research Groups,La Isla Network
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- Chavarria, D. (author)
- Nicaragua Sugar Estates Limited
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- Glaser, J. (author)
- La Isla Network
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- Jakobsson, Kristina (author)
- University of Gothenburg,Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine,Sahlgrenska University Hospital,Sahlgrenska Academy,La Isla Network
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(creator_code:org_t)
- 2022-11-18
- 2022
- English.
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In: Bmj Open. - : BMJ. - 2044-6055. ; 12:11
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Abstract
Subject headings
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- OBJECTIVES: Heat-stressed Mesoamerican workers, such as sugarcane cutters, suffer from high rates of chronic kidney disease of non-traditional origin (CKDnt). We aimed to identify easily available early markers of rapid kidney function decline in a population at high risk of CKDnt. DESIGN: The accuracy of different biomarkers measured during harvest for prediction of cross-harvest kidney function decline were assessed in an exploratory study group, and the performance of the most promising biomarker was then assessed in an independent confirmation group. SETTING: Male sugarcane cutters in El Salvador and Nicaragua. PARTICIPANTS: 39 male Salvadoran sugarcane cutters sampled fortnightly at ≤9 occasions before and after work shift during harvest. 371 male Nicaraguan sugarcane cutters were sampled as part of routine monitoring during two harvests. Cutters worked at high physical intensity at wet-bulb globe temperatures mostly above 29°C for 6-8hours per day 6 days a week during the 5-6months harvest season. PRIMARY OUTCOMES: Change in estimated glomerular filtration rate (CKD Epidemiology Collaboration) across the harvest season (ΔeGFRcross-harvest). RESULTS: Dipstick leukocyturia after work shift in the El Salvadoran group was the most promising marker, explaining >25% of ΔeGFRcross-harvest variance at 8/9 occasions during harvest. Leukocyturia was associated with experiencing fever, little or dark urine, cramps, headache, dizziness and abdominal pain in the preceding 2-week period. Decreasing blood haemoglobin (Hb) and eGFR during harvest were also predictive of ΔeGFRcross-harvest. In the Nicaraguan confirmation dataset, those having ≥++ leukocyturia at any sampling during harvest had a 13 mL/min/1.73 m2 (95% CI 10 to 16mL/min/1.73 m2) worse ΔeGFRcross-harvest than those without recorded leukocyturia. CONCLUSION: Leukocyturia and Hb, both measurable with point-of-care methods, may be early indicators for kidney injury and risk for eGFR decline among heat-stressed male workers, thereby facilitating individual-level prevention and research aiming to understand the causes of CKDnt.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)
Keyword
- acute renal failure
- chronic renal failure
- occupational & industrial medicine
Publication and Content Type
- ref (subject category)
- art (subject category)
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