Park Min Young, Kang Mo-Yeol
Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
J Korean Med Sci. 2025 Aug 11;40(31):e224. doi: 10.3346/jkms.2025.40.e224.
Chronic kidney disease (CKD) is a major global health concern, with traditional risk factors such as diabetes and hypertension well established. However, emerging evidence suggests that occupational exposures could play a significant role in CKD development. This review comprehensively summarizes the current evidence concerning occupational risk factors contributing to kidney disease, including exposure to heavy metals (lead, cadmium, mercury, chromium), organic solvents (trichloroethylene, methanol, ethylene glycol), heat stress, and job-related stress factors (occupational stress, long working hours, shift work). Epidemiological studies indicate that nephrotoxic agents contribute to renal dysfunction through oxidative stress, mitochondrial damage, and impaired ion transport. Industries such as manufacturing, agriculture, and mining pose particularly high risks due to hazardous exposures. While strong evidence links nephrotoxic metals and solvents to early renal dysfunction, the long-term effects of chronic low-dose exposure remain unclear. Additionally, heat stress-related CKD, particularly Meso-American nephropathy, highlights the growing concern of climate-related occupational risks. Job-related stress factors, including long working hours and shift work, may further accelerate CKD progression through stress-induced hypertension and metabolic disturbances. Given the substantial public health implications, preventive strategies should focus on reducing workplace exposures, implementing heat stress management programs, and addressing the impact of job-related stress factors.
慢性肾脏病（CKD）是一个重大的全球健康问题，糖尿病和高血压等传统风险因素已广为人知。然而，新出现的证据表明，职业暴露可能在CKD的发展中起重要作用。本综述全面总结了目前有关导致肾脏疾病的职业风险因素的证据，包括接触重金属（铅、镉、汞、铬）、有机溶剂（三氯乙烯、甲醇、乙二醇）、热应激以及与工作相关的压力因素（职业压力、长时间工作、轮班工作）。流行病学研究表明，肾毒性物质通过氧化应激、线粒体损伤和离子转运受损导致肾功能障碍。制造业、农业和采矿业等行业由于接触有害物质而面临特别高的风险。虽然有力的证据将肾毒性金属和溶剂与早期肾功能障碍联系起来，但长期低剂量接触的长期影响仍不清楚。此外，与热应激相关的CKD，特别是中美洲肾病，凸显了对与气候相关的职业风险的日益关注。与工作相关的压力因素，包括长时间工作和轮班工作，可能通过压力诱导的高血压和代谢紊乱进一步加速CKD的进展。鉴于对公众健康有重大影响，预防策略应侧重于减少工作场所暴露、实施热应激管理计划以及应对与工作相关的压力因素的影响。
