| Title: |
Point-of-care biomarkers for prediction of kidney function trajectory among sugarcane cutters: a comparative test accuracy study |
| Authors: |
Hansson, Erik; Wesseling, Catharina; Wegman, David; Ekström, Ulf; Chavarria, Denis; Glaser, Jason; Jakobsson, Kristina |
| Contributors: |
Belmont Forum; German Ministry for Economic Development and Cooperation; Stavros Niarchos Foundation; German Investment Corporation; Dutch National Postcode Lottery; Forskningsrådet om Hälsa, Arbetsliv och Välfärd; Solidaridad; ISA |
| Source: |
BMJ Open ; volume 12, issue 11, page e060364 ; ISSN 2044-6055 2044-6055 |
| Publisher Information: |
BMJ |
| Publication Year: |
2022 |
| Description: |
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 6–8 hours per day 6 days a week during the 5–6 months harvest season. Primary outcomes Change in estimated glomerular filtration rate (CKD Epidemiology Collaboration) across the harvest season (ΔeGFR cross-harvest ). Results Dipstick leukocyturia after work shift in the El Salvadoran group was the most promising marker, explaining >25% of ΔeGFR cross-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 ΔeGFR cross-harvest . In the Nicaraguan confirmation dataset, those having ≥++ leukocyturia at any sampling during harvest had a 13 mL/min/1.73 m 2 (95% CI 10 to 16 mL/min/1.73 m 2 ) worse ΔeGFR cross-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 ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1136/bmjopen-2021-060364 |
| Availability: |
https://doi.org/10.1136/bmjopen-2021-060364; https://syndication.highwire.org/content/doi/10.1136/bmjopen-2021-060364 |
| Rights: |
https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.FD210236 |
| Database: |
BASE |