Submission ID 130544
| Issue/Objective | Chronic kidney disease of unknown etiology (CKDu) is an emerging global health crisis affecting young agricultural workers without traditional risk factors. Heat stress, dehydration, and strenuous labor appear to be key drivers. However, longitudinal evidence, especially on occupational differences and age-related renal decline, remains limited. This study aimed to characterize longitudinal changes in mean estimated glomerular filtration rate (eGFR), assess heterogeneity in renal function decline across age strata and occupational groups, and examine patterns of renal function decline, including potential early-onset impairment among sugarcane workers. |
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| Methodology/Approach | We conducted a prospective cohort study in San Jacinto, Peru, in 2021-22 that followed sugarcane farmers and non-farmer workers. Baseline assessments were done in September-December 2021 (n=380) and 12-month follow-up in August-November 2022 (n=372), with questionnaires, anthropometrics and measures of blood pressure and serum creatinine. Estimated glomerular filtration rate (eGFR, mL/min/ 1.73 m²) was calculated using CKD-EPI. Difference-in-differences (DiD) models, adjusted for relevant confounders, compared one-year eGFR changes overall, by age (younger workers <43 vs older workers ≥43 years), and by occupational groups (cane cutters, seed cutters, seeders vs factory/administrative). |
| Results | Median age was 43 years in farmers and non-farmer workers. At baseline, farmers had lower education and income, less alcohol and tobacco use, and higher blood pressure prevalence than non-farmers. Over 12 months, adjusted DiD model eGFR declined more in farmers than in non-farmers (−5.46, 95% CI −7.85 to −3.07). The decline was greater among younger workers of <43 years (−6.55, 95% CI −10.03 to −3.06). Cane cutters (−5.65, 95% CI −8.45 to −2.85) and seed cutters (−5.51, 95% CI −10.11 to −0.92) had the largest losses compared to other occupational groups. |
| Discussion/Conclusion | Sugarcane farmers, particularly younger workers involved in cane and seed cutting, experienced a greater decline in kidney function over one year than non-farmer workers. These findings suggest the important of occupational preventive measures, including heat and workload controls, structured rest, shade, hydration, and routine renal screening, to support early detection and prevention of CKDu in this workforce. |
| Presenters and Affiliations | Janina Bazalar-Palacios Universidad Privada Norbert Wiener Maria Palacios Universidad Católica los Angeles de Chimbote Antonio Bernabé-Ortiz Universidad Científica del Sur Tim Driscoll Sydney School of Public Health The University of Sydney Brenda Pillaca Universidad Privada Norbert Wiener Juan Carlos Bazo-Alvarez Research Department of Primary Care and Population Health, University College London |
