scholarly journals Environment and chronic kidney disease in farmers

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kei Nagai
Keyword(s):  
Chronic Kidney Disease ◽  
Global Warming ◽  
Heat Stress ◽  
Kidney Disease ◽  
Interstitial Nephritis ◽  
Epidemiological Studies ◽  
Additional Risk Factor ◽  
Farm Work ◽  
Agricultural Communities ◽  
Chronic Interstitial Nephritis

AbstractThe prevalence of chronic kidney disease (CKD) has been on the rise worldwide. Epidemiological studies performed primarily in Central America and South Asia have reported high prevalence of CKD among young and middle-aged men working in agricultural communities. The clinical features do not appear linked to any classical CKD risk factors, such as hypertension, diabetes, or chronic nephritis. The disease develops and progresses as interstitial nephritis, without showing noticeable symptoms or high levels of proteinuria. Pathologically, the disease essentially represents chronic interstitial nephritis and is termed chronic interstitial nephritis in agricultural communities (CINAC). The potential causes of CINAC include: (1) heat stress-related factors associated with increased ambient temperatures resulting from global warming; and (2) factors connected with exposure to agrochemicals and/or pesticides. Global warming and environmental pollution will undoubtedly pose a significant health risk to farmers, and heat stress during farm work could easily result in the development and progression of CKD. Japanese agricultural regions evidently will not be spared from global environmental changes. For future epidemiological studies, researchers should establish a more comprehensive analytical method that can incorporate additional risk-factor variables, such as occupational history (including agricultural work) and ambient temperature.

Chronic kidney disease mortality trends in selected Central America countries, 1997–2013: clues to an epidemic of chronic interstitial nephritis of agricultural communities

2018 ◽  
Vol 72 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Pedro Ordunez ◽  
F Javier Nieto ◽  
Ramon Martinez ◽  
Patricia Soliz ◽  
Gloria P Giraldo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Heat Stress ◽  
Kidney Disease ◽  
Central America ◽  
Interstitial Nephritis ◽  
Statistical Modelling ◽  
Mortality Trends ◽  
Mortality Pattern ◽  
Agricultural Communities ◽  
Chronic Interstitial Nephritis

BackgroundIn Central America, chronic interstitial nephritis of agricultural communities (CINAC) has reached epidemic proportions. Clusters of cases have been described in several farming communities. Its aetiology remains uncertain and a controversy exists on its key triggers, among them the heat stress–dehydration mechanism and the toxic exposure to agrochemicals.MethodsThis study analysed the mortality pattern and trend of chronic kidney disease code N18 (CKD-N18) according to the International Statistical Classification of Diseases and Related Health Problems-10th Revision, the proxy and the underlying cause of death, in four selected Central American countries from 1997 to 2013. In addition, we used exponential regression to retrospectively model the likely onset and prior trajectory of the epidemic.ResultsBetween 1997 and 2013, CKD-N18 mortality accounting 47 885 deaths (31% were female), 19 533 of which occurred below 60 years of age (26% female). The excess of mortality starts as early as 10–14 years of age for both boys and girls. El Salvador and Nicaragua, with mortality rates between 9-fold and 12-fold higher than reference countries, were the most affected. Statistical modelling suggests that the epidemic commenced around the mid-1970s, coinciding with important changes in modes of agricultural production.ConclusionsThis study provides the most comprehensive mortality analysis of this epidemic published to date and confirms an excess of CKD-N18 mortality and its relation with the epidemic of CINAC. The overall trends and the mortality pattern among women, children and adolescents suggest that the heat stress–dehydration hypothesis cannot fully explain this epidemic and that other environmental factors, more likely agricultural practices and agrochemicals, may be causally involved.

Chronic Interstitial Nephritis

2017 ◽  
Author(s):  
Gearoid M McMahon
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Interstitial Nephritis ◽  
Renal Diseases ◽  
Balkan Endemic Nephropathy ◽  
Tubular Atrophy ◽  
Common Causes ◽  
Endemic Nephropathy ◽  
Mesoamerican Nephropathy ◽  
Chronic Interstitial Nephritis

Chronic interstitial nephritis is a progressive kidney disease with a wide variety of causes characterized by the presence of tubulointerstitial fibrosis, inflammation, and tubular atrophy. Most patients with advanced chronic kidney disease will have at least some degree of chronic interstitial nephritis present on a renal biopsy. However, there is a subset of renal diseases that specifically target the interstitium, leading to a progressive decline in kidney function. This review discusses the pathology and pathophysiology of chronic interstitial nephritis. In addition, common causes are reviewed, with a particular emphasis on recently described variants, including genetic causes of interstitial nephritis, Mesoamerican nephropathy, Balkan endemic nephropathy, and IgG4-related kidney disease. Key words: Chronic Kidney Disease, Inflammation, Fibrosis, 

scholarly journals Experimental heat stress nephropathy and liver injury are improved by allopurinol

2018 ◽  
Vol 315 (3) ◽  
pp. F726-F733 ◽  
Author(s):  
Carlos A. Roncal-Jimenez ◽  
Yuka Sato ◽  
Tamara Milagres ◽  
Ana Andres Hernando ◽  
Gabriela García ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Renal Function ◽  
Heat Stress ◽  
Kidney Disease ◽  
Liver Injury ◽  
Central America ◽  
Uric Acid Concentration ◽  
Collagen Deposition ◽  
Renal Protection ◽  
Xanthine Oxidase Inhibitor

An epidemic of chronic kidney disease (CKD) has been observed in Central America among workers in the sugarcane fields. One hypothesis is that the CKD may be caused by recurrent heat stress and dehydration, and potentially by hyperuricemia. Accordingly, we developed a murine model of kidney injury associated with recurrent heat stress. In the current experiment, we tested whether treatment with allopurinol (a xanthine oxidase inhibitor that reduces serum urate) provides renal protection against recurrent heat stress and dehydration. Eight-week-old male C57BL/6 mice were subjected to recurrent heat stress (39.5°C for 30 min, 7 times daily, for 5 wk) with or without allopurinol treatment and were compared with control animals with or without allopurinol treatment. Mice were allowed ad libitum access to normal laboratory chow (Harlan Teklad). Kidney histology, liver histology, and renal function were examined. Heat stress conferred both kidney and liver injury. Kidneys showed loss of proximal tubules, infiltration of monocyte/macrophages, and interstitial collagen deposition, while livers of heat-stressed mice displayed an increase in macrophages, collagen deposition, and myofibroblasts. Allopurinol provided significant protection and improved renal function in the heat-stressed mice. The renal protection was associated with reduction in intrarenal uric acid concentration and heat shock protein 70 expression. Heat stress-induced renal and liver injury can be protected with allopurinol treatment. We recommend a clinical trial of allopurinol for individuals developing renal injury in rural areas of Central America where the epidemic of chronic kidney disease is occurring.

scholarly journals Egg Intake in Chronic Kidney Disease

Nutrients ◽  
2018 ◽  
Vol 10 (12) ◽  
pp. 1945 ◽  
Author(s):  
Dina Tallman ◽  
Sharmela Sahathevan ◽  
Tilakavati Karupaiah ◽  
Pramod Khosla
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Dietary Cholesterol ◽  
Egg Yolk ◽  
Epidemiological Studies ◽  
Egg Consumption ◽  
Stage Renal Disease ◽  
The Impact

Patients with chronic kidney disease (CKD) are often instructed to adhere to a renal-specific diet depending on the severity and stage of their kidney disease. The prescribed diet may limit certain nutrients, such as phosphorus and potassium, or encourage the consumption of others, such as high biological value (HBV) proteins. Eggs are an inexpensive, easily available and high-quality source of protein, as well as a rich source of leucine, an essential amino acid that plays a role in muscle protein synthesis. However, egg yolk is a concentrated source of both phosphorus and the trimethylamine N-oxide precursor, choline, both of which may have potentially harmful effects in CKD. The yolk is also an abundant source of cholesterol which has been extensively studied for its effects on lipoprotein cholesterol and the risk of cardiovascular disease. Efforts to reduce dietary cholesterol to manage dyslipidemia in dialysis patients (already following a renal diet) have not been shown to offer additional benefit. There is a paucity of data regarding the impact of egg consumption on lipid profiles of CKD patients. Additionally, egg consumption has not been associated with the risk of developing CKD based on epidemiological studies. The egg yolk also contains bioactive compounds, including lutein, zeaxanthin, and vitamin D, which may confer health benefits in CKD patients. Here we review research on egg intake and CKD, discuss both potential contraindications and favorable effects of egg consumption, and describe the need for further research examining egg intake and outcomes in the CKD and end-stage renal disease population.

scholarly journals ASSESSMENT OF LIPID PROFILE AMONG PATIENTS OF NON-DIABETIC CHRONIC KIDNEY DISEASE AT TERTIARY CARE CENTRE

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Dr Bakul Gupta
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Disease ◽  
Lipid Profile ◽  
Chronic Renal Disease ◽  
Tertiary Care ◽  
Study Participant ◽  
P Value ◽  
Additional Risk Factor ◽  
Study Participants

Background: Various studies have shown the association between dyslipidemia and cardio-vascular risk among patients of chronic renal disease but the association non-significant than patients with normal renal function. There was lack of evidence exists because patients with chronic renal disease were excluded from the major clinical studies where the association with that target dyslipidemia treatment was being evaluated Material & Methods: The present prospective study was conducted among the patients of Chronic Kidney Disease above 18 years of age and diagnosed on the basis of history, detailed clinical examination, and biochemical and sonological examination based upon National Kidney Foundation (NKF) criteria were enrolled into the study. Clearance from hospital ethics committee was taken before start of study. Written informed consent was taken from each study participant. Results:  In the present study out of total study participants of chronic kidney disease 46% were in the 3rd stage of CKD, 38% were in the 4th stage of CKD and 16% were in the 5th stage of CKD. Out of total study participants of chronic kidney disease, 82% were managed by conservative treatment and 18% were being managed by hemodialysis. Out of total study participants of chronic kidney disease, 38% had normal lipid profile while 62% patients had dyslipidemia. We found statistically significant (p value < 0.05) association between dyslipidemia and hemodialysis and association between dyslipidemia and stages of chronic kidney disease was statistically non- significant (p value > 0.05). Conclusion:  We concluded from the present study that dyslipidemia is significantly associated as an additional risk factor in patients of Chronic Kidney Disease. We found significant association of hemodialysis with abnormal lipid profile. Key words: Chronic kidney disease, dyslipidemia, hemodialysis.

scholarly journals L’importanza del vaccino anti Covid-19 nei pazienti affetti da malattia del rene policistico autosomico dominante dell’adulto (ADPKD)

2021 ◽  
Vol 33 ◽  
pp. 84-87
Author(s):  
Maria Teresa Sciarrone Alibrandi ◽  
Giancarlo Joli ◽  
Rodolfo F. Rivera ◽  
Elena Brioni ◽  
Romina Bucci ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Risk Factor ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Point Of View ◽  
Additional Risk Factor ◽  
Additional Risk ◽  
The Moment ◽  
Clear Relation ◽  
Related Mortality

The SARS-CoV-2 (Covid-19) infection affected about 106 million people worldwide and the total amount of casualties now sits at a staggering 2 millions. Chronic Kidney Disease (CKD) emerged as the first risk factor in worst patients, not considering old age. Kidney disease and acute kidney injury have been correlated with a higher chance of death. This combination of CKD and higher Covid-19 related mortality requires immediate response from a prevention point of view at first and then from a therapeutic one. There is not a clear relation between Covid-19 and ADPKD. What can be inferred is the following: Covid uses the ACE2 receptors on cell membranes to “lock on” its target. It is well-established in fact that the RAAS is more active in ADPKD patients and it may represent an additional risk factor for these patients. At the moment three Covid-19 vaccines have been approved, and two of them have been already administered, such as Pfizer BioNTech and Moderna, sharing the same mechanism. AstraZeneca released a third option. All of them are completely safe and reliable, each one with its own feature. Therefore, considering how delicate ADPKD patients are, vaccination is strongly recommended.

scholarly journals Chronic kidney disease of non-traditional origin in Mesoamerica: a disease primarily driven by occupational heat stress

2020 ◽  
Vol 44 ◽  
pp. 1 ◽  
Author(s):  
Catharina Wesseling ◽  
Jason Glaser ◽  
Julieta Rodríguez-Guzmán ◽  
Ilana Weiss ◽  
Rebekah Lucas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Kidney Disease ◽  
Heat Stress ◽  
Kidney Disease ◽  
Kidney Function ◽  
Population Based ◽  
Occupational Risk Factors ◽  
Infectious Risk ◽  
Main Driver ◽  
Low Prevalence

The death toll of the epidemic of chronic kidney disease of nontraditional origin (CKDnt) in Mesoamerica runs into the tens of thousands, affecting mostly young men. There is no consensus on the etiology. Anecdotal evidence from the 1990s pointed to work in sugarcane; pesticides and heat stress were suspected. Subsequent population-based surveys supported an occupational origin with overall high male-female ratios in high-risk lowlands, but small sex differences within occupational categories, and low prevalence in non-workers. CKDnt was reported in sugarcane and other high-intensity agriculture, and in non-agricultural occupations with heavy manual labor in hot environments, but not among subsistence farmers. Recent studies with stronger designs have shown cross-shift changes in kidney function and hydration biomarkers and cross-harvest kidney function declines related to heat and workload. The implementation of a water-rest-shade intervention midharvest in El Salvador appeared to halt declining kidney function among cane cutters. In Nicaragua a water-rest-shade program appeared sufficient to prevent kidney damage among cane workers with low-moderate workload but not among cutters with heaviest workload. Studies on pesticides and infectious risk factors have been largely negative. Non-occupational risk factors do not explain the observed epidemiologic patterns. In conclusion, work is the main driver of the CKDnt epidemic in Mesoamerica, with occupational heat stress being the single uniting factor shown to lead to kidney dysfunction in affected populations. Sugarcane cutters with extreme heat stress could be viewed as a sentinel occupational population. Occupational heat stress prevention is critical, even more so in view of climate change.

scholarly journals Physical activity in chronic kidney disease and the EXerCise Introduction To Enhance trial

2020 ◽  
Vol 35 (Supplement_2) ◽  
pp. ii18-ii22 ◽  
Author(s):  
Francesca Mallamaci ◽  
Anna Pisano ◽  
Giovanni Tripepi
Keyword(s):  
Physical Activity ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Sedentary Lifestyle ◽  
Public Health Problem ◽  
Epidemiological Studies ◽  
Dialysis Patients ◽  
Increased Risk ◽  
Reduced Physical Activity

Abstract It is well known from observational studies that sedentary lifestyle and reduced physical activity are common in dialysis and chronic kidney disease (CKD) patients and associate with an increased risk of morbidity and mortality in this patient population. Epidemiological studies indicate that CKD patients undergo physical activity ~9 days/month and 43.9% of dialysis patients report not exercising at all. On the basis of awareness about the strong link between sedentary lifestyle and adverse clinical outcomes, the National Kidney Foundation and Kidney Disease: Improving Global Outcomes have provided specific recommendations for physical activity in patients with kidney disease. Given the fact that CKD is a public health problem and it is still debated which type of exercise should be prescribed in these patients, this review focuses on the most robust evidence accumulated so far on the beneficial effect of various types of physical exercise on clinical outcomes in CKD and dialysis patients. This review does not treat this very important topic in another CKD category of patients, such as kidney-transplanted patients, for whom a special issue should be dedicated.

scholarly journals Pathophysiological Mechanisms by which Heat Stress Potentially Induces Kidney Inflammation and Chronic Kidney Disease in Sugarcane Workers

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1639 ◽  
Author(s):  
Erik Hansson ◽  
Jason Glaser ◽  
Kristina Jakobsson ◽  
Ilana Weiss ◽  
Catarina Wesseling ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Blood Flow ◽  
Heat Stress ◽  
Kidney Disease ◽  
Renal Blood Flow ◽  
Empirical Support ◽  
Kidney Injury ◽  
Theoretical Framework ◽  
Successful Resolution ◽  
Strenuous Work

Background: Chronic kidney disease of non-traditional origin (CKDnt) is common among Mesoamerican sugarcane workers. Recurrent heat stress and dehydration is a leading hypothesis. Evidence indicate a key role of inflammation. Methods: Starting in sports and heat pathophysiology literature, we develop a theoretical framework of how strenuous work in heat could induce kidney inflammation. We describe the release of pro-inflammatory substances from a leaky gut and/or injured muscle, alone or in combination with tubular fructose and uric acid, aggravation by reduced renal blood flow and increased tubular metabolic demands. Then, we analyze longitudinal data from >800 sugarcane cutters followed across harvest and review the CKDnt literature to assess empirical support of the theoretical framework. Results: Inflammation (CRP elevation and fever) and hyperuricemia was tightly linked to kidney injury. Rehydrating with sugary liquids and NSAID intake increased the risk of kidney injury, whereas electrolyte solution consumption was protective. Hypokalemia and hypomagnesemia were associated with kidney injury. Discussion: Heat stress, muscle injury, reduced renal blood flow and fructose metabolism may induce kidney inflammation, the successful resolution of which may be impaired by daily repeating pro-inflammatory triggers. We outline further descriptive, experimental and intervention studies addressing the factors identified in this study.

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