Department of Environmental Health, Faculty of Public Health, University of Indonesia, Depok 16424, Indonesia.
Department of Epidemiology, Faculty of Public Health, University of Indonesia, Depok 16424, Indonesia.
Int J Environ Res Public Health. 2020 Jun 23;17(12):4521. doi: 10.3390/ijerph17124521.
Chronic kidney disease of unknown etiology (CKDu) in agricultural population is an increasing issue. This study aims to obtain a prevalence estimate of CKDu in male rice farmers in West Java, Indonesia; and analyze the relationship between CKDu and environmental and occupational factors. The study design was cross-sectional. This study included 354 healthy male farmers in two rice agriculture areas in West Java with different altitudes (low altitude and high-altitude location). This research included blood and urine sampling from the farmers for serum creatinine (SCr) level and proteinuria; questionnaire on demographic information, occupational factors and other risk factors for CKDu. We measured ambient temperature and humidity in both study locations for environmental factors. From SCr level and proteinuria, we categorized the farmers into five stages of CKD; then we distinguished CKDu from CKD if the farmers had stage 1-4 of CKD but without diabetes, hypertension and other traditional causes. Data were analyzed with multivariate logistic regression to get prevalence odd ratios of CKDu and its relationship with environmental and occupational factors, adjusted with other risk factors of CKDu. The overall prevalence of CKD was 24.9% and CKDu was 18.6%. For the environmental factors, farm location (high altitude versus low altitude location) was associated with CKDu (Prevalence Odds Ratio (POR): 2.0; 95% CI: 1.2-3.5). For the occupational factors, although not significant, the risk of CKDu increased with the longer use of insecticide and with the more frequent of insecticide use. We suggested that there was a need to conduct future research to investigate more on the association of those environmental and occupational factors with CKDu.
原因不明的慢性肾病（CKDu）在农业人群中是一个日益严重的问题。本研究旨在获得印度尼西亚西爪哇男性稻农中 CKDu 的患病率估计，并分析 CKDu 与环境和职业因素之间的关系。研究设计为横断面研究。本研究纳入了西爪哇两个不同海拔高度（低海拔和高海拔地区）水稻种植区的 354 名健康男性农民。本研究包括从农民身上采集血液和尿液样本，用于检测血清肌酐（SCr）水平和蛋白尿；并通过问卷调查收集农民的人口统计学信息、职业因素和其他 CKDu 危险因素。我们测量了两个研究地点的环境温度和湿度。根据 SCr 水平和蛋白尿，我们将农民分为五个阶段的慢性肾脏病；然后，如果农民患有 1-4 期慢性肾脏病，但没有糖尿病、高血压和其他传统病因，我们将其与 CKDu 区分开来。我们采用多变量逻辑回归分析数据，以获得 CKDu 的患病率比值比及其与环境和职业因素的关系，并调整了其他 CKDu 的危险因素。慢性肾脏病的总患病率为 24.9%，CKDu 的患病率为 18.6%。就环境因素而言，农场位置（高海拔与低海拔地区）与 CKDu 相关（患病率比值比（POR）：2.0；95%置信区间：1.2-3.5）。就职业因素而言，尽管没有统计学意义，但使用杀虫剂时间较长和使用杀虫剂频率较高的农民，CKDu 的风险增加。我们建议需要开展未来的研究，以进一步调查这些环境和职业因素与 CKDu 的关系。
