National Autonomous University of Nicaragua, León (UNAN-León), León, Nicaragua.
Department of Environmental Health, Boston University School of Public Health, Boston, MA.
Am J Kidney Dis. 2019 Aug;74(2):239-247. doi: 10.1053/j.ajkd.2019.01.017. Epub 2019 Feb 27.
RATIONALE & OBJECTIVE: In Central America, there is a high prevalence of chronic kidney disease (CKD) of nontraditional etiology often observed among agricultural workers. Few studies have assessed CKD prevalence among workers in nonagricultural occupations, which was the objective of this investigation.
Prospective cohort study.
SETTING & PARTICIPANTS: Male and female workers (n = 224) employed by artisanal brickmaking facilities in La Paz Centro, Nicaragua.
Age, sex, education, smoking status, body mass index, alcohol consumption, water consumption, first-degree relative(s) with CKD, years worked, hours worked per week, job category, study visit (baseline and follow-up), and self-reported hypertension and diabetes.
CKD defined as estimated glomerular filtration rate (eGFR) < 60mL/min/1.73m at 2 time points 4 months apart and CKD stage.
A linear mixed-effects model with an unstructured covariance matrix was used to evaluate the association between demographics, occupational risk factors, and eGFR at baseline. The interaction between risk factors and time with change in eGFR was also evaluated. Multivariable logistic regression models were used to evaluate predictors of CKD.
The CKD prevalence was 12.1% (n = 27), 100% of cases were male, 30% had stage 5 CKD (eGFR < 15mL/min/1.73m), and 22% were younger than 35 years. Proportions of participants with eGFRs < 60mL/min/1.73m at baseline and follow-up were 13.8% and 15.2%, respectively. Linear regression analysis demonstrated significant predictors of lower kidney function at baseline including oven work, older age, lack of education, and having an immediate family member with CKD. Predictors of CKD identified using logistic regression analysis included oven work and lack of education.
Crude job classification measures, loss to follow-up, self-reported exposures.
The prevalence of CKD is high in this population of brick workers, suggesting that the epidemic of CKD affecting Mesoamerica is not limited to agricultural workers. These results are consistent with the hypothesis that occupational heat exposure is a risk factor for kidney disease in this region.
在中美洲，非传统病因引起的慢性肾脏病（CKD）的发病率很高，这种情况经常在农业工人中观察到。很少有研究评估非农业职业工人的 CKD 患病率，这是本研究的目的。
前瞻性队列研究。
在尼加拉瓜拉巴斯中心的手工制砖厂工作的男性和女性工人（n = 224）。
年龄、性别、教育程度、吸烟状况、体重指数、饮酒量、水摄入量、一级亲属（CKD 患者）、工作年限、每周工作小时数、工作类别、研究访问（基线和随访）以及自我报告的高血压和糖尿病。
CKD 定义为在 4 个月的两次间隔时间内，估计肾小球滤过率（eGFR）<60mL/min/1.73m，以及 CKD 分期。
使用无结构协方差矩阵的线性混合效应模型来评估人口统计学、职业危险因素与基线时 eGFR 之间的关系。还评估了危险因素与 eGFR 变化之间的相互作用。多变量逻辑回归模型用于评估 CKD 的预测因素。
CKD 的患病率为 12.1%（n = 27），100%为男性，30%为 5 期 CKD（eGFR<15mL/min/1.73m），22%年龄小于 35 岁。基线和随访时 eGFR<60mL/min/1.73m 的参与者比例分别为 13.8%和 15.2%。线性回归分析表明，基线时肾功能较低的显著预测因素包括烤箱工作、年龄较大、缺乏教育以及一级亲属有 CKD。使用逻辑回归分析确定的 CKD 预测因素包括烤箱工作和缺乏教育。
粗糙的工作分类措施、随访丢失、自我报告的暴露。
在这个砖工人群中，CKD 的患病率很高，这表明影响中美洲的 CKD 流行不仅限于农业工人。这些结果与职业热暴露是该地区肾脏疾病危险因素的假设一致。
