Creatinine Fluctuations Forecast Cross-Harvest Kidney Function Decline Among Sugarcane Workers in Guatemala.
AKI
agricultural workers
chronic kidney disease of unknown origin
forecasting
kidney function decline
occupational health
Journal
Kidney international reports
ISSN: 2468-0249
Titre abrégé: Kidney Int Rep
Pays: United States
ID NLM: 101684752
Informations de publication
Date de publication:
Sep 2020
Sep 2020
Historique:
received:
25
02
2020
revised:
09
06
2020
accepted:
23
06
2020
entrez:
21
9
2020
pubmed:
22
9
2020
medline:
22
9
2020
Statut:
epublish
Résumé
Chronic kidney disease of unknown origin (CKDu) is an epidemic that disproportionately affects young agriculture workers in hot regions. It has been hypothesized that repeated acute kidney injury (AKI) may play a role in the development of disease. Latent class mixed models were used to identify groups of Guatemalan sugarcane harvesters based on their daily changes in creatinine over 6 consecutive days in 2018. Exponential smoothing state space models were used to forecast end-of-season creatinine between the identified groups. Percent change in estimated glomerular filtration rate (eGFR) across the harvest was compared between groups. Twenty-nine percent (n = 30) of the 103 workers experienced repeated severe fluctuations in creatinine across shift. The model with multiplicative error, multiplicative trend, and multiplicative seasonality was able to accurately forecast end-of-season creatinine in the severe group (mean percentage error [MPE]: -4.7%). eGFR of workers in the severe group on average decreased 20% across season compared to 11% decline for those in the moderate group (95% confidence interval for difference: -17% to 0%). Daily fluctuations in creatinine can be used to forecast end-of-season creatinine in sugarcane harvesters. Workers who experience repeat severe daily fluctuations in creatinine, on average, experience a greater reduction in kidney function across the season.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic kidney disease of unknown origin (CKDu) is an epidemic that disproportionately affects young agriculture workers in hot regions. It has been hypothesized that repeated acute kidney injury (AKI) may play a role in the development of disease.
METHODS
METHODS
Latent class mixed models were used to identify groups of Guatemalan sugarcane harvesters based on their daily changes in creatinine over 6 consecutive days in 2018. Exponential smoothing state space models were used to forecast end-of-season creatinine between the identified groups. Percent change in estimated glomerular filtration rate (eGFR) across the harvest was compared between groups.
RESULTS
RESULTS
Twenty-nine percent (n = 30) of the 103 workers experienced repeated severe fluctuations in creatinine across shift. The model with multiplicative error, multiplicative trend, and multiplicative seasonality was able to accurately forecast end-of-season creatinine in the severe group (mean percentage error [MPE]: -4.7%). eGFR of workers in the severe group on average decreased 20% across season compared to 11% decline for those in the moderate group (95% confidence interval for difference: -17% to 0%).
CONCLUSIONS
CONCLUSIONS
Daily fluctuations in creatinine can be used to forecast end-of-season creatinine in sugarcane harvesters. Workers who experience repeat severe daily fluctuations in creatinine, on average, experience a greater reduction in kidney function across the season.
Identifiants
pubmed: 32954081
doi: 10.1016/j.ekir.2020.06.032
pii: S2468-0249(20)31355-3
pmc: PMC7486184
doi:
Types de publication
Journal Article
Langues
eng
Pagination
1558-1566Subventions
Organisme : NIDDK NIH HHS
ID : P30 DK048520
Pays : United States
Organisme : NIEHS NIH HHS
ID : R21 ES028826
Pays : United States
Informations de copyright
© 2020 International Society of Nephrology. Published by Elsevier Inc.
Références
J Occup Environ Med. 2018 Jun;60(6):548-558
pubmed: 29370016
Ann Nutr Metab. 2015;66 Suppl 3:10-3
pubmed: 26088040
N Engl J Med. 2019 May 9;380(19):1843-1852
pubmed: 31067373
Int J Occup Environ Health. 2015 Jul-Sep;21(3):241-50
pubmed: 25631575
J Am Soc Nephrol. 2018 Aug;29(8):2200-2212
pubmed: 29907699
N Engl J Med. 2014 Jul 3;371(1):58-66
pubmed: 24988558
Int Arch Occup Environ Health. 2019 Oct;92(7):977-990
pubmed: 30997573
Am J Kidney Dis. 2018 Oct;72(4):469-471
pubmed: 30244694
Kidney Int. 2015 Apr;87(4):792-9
pubmed: 25229334
Am J Kidney Dis. 2014 Mar;63(3):396-404
pubmed: 24140367
Rev Panam Salud Publica. 2016 Nov;40(5):294-300
pubmed: 28076577
J Occup Environ Med. 2019 Mar;61(3):239-250
pubmed: 30575695
Clin J Am Soc Nephrol. 2016 Aug 8;11(8):1472-83
pubmed: 27151892
Kidney Int Rep. 2017 Oct 24;3(2):271-280
pubmed: 29725631
Am J Kidney Dis. 2018 Oct;72(4):475-482
pubmed: 30042041
Am J Kidney Dis. 2014 Mar;63(3):506-20
pubmed: 24412050
N Engl J Med. 2019 Aug 22;381(8):693-696
pubmed: 31433914
PLoS One. 2018 Sep 27;13(9):e0204614
pubmed: 30261074
Nephron. 2017;136(4):302-308
pubmed: 28441651
Environ Res. 2015 Oct;142:746-55
pubmed: 26209462
Br J Sports Med. 2002 Aug;36(4):301-3
pubmed: 12145122
Semin Nephrol. 2016 Jan;36(1):31-41
pubmed: 27085733
Ann Intern Med. 2009 May 5;150(9):604-12
pubmed: 19414839
PLoS One. 2018 Oct 5;13(10):e0205181
pubmed: 30289894
Stat Methods Med Res. 2014 Feb;23(1):74-90
pubmed: 22517270
Clin Kidney J. 2018 Aug;11(4):496-506
pubmed: 30094014
Environ Res. 2016 May;147:125-32
pubmed: 26866450