Changes in kidney function among Nicaraguan sugarcane workers

Int J Occup Environ Health. 2015 Jul-Sep;21(3):241-50. doi: 10.1179/2049396714Y.0000000102. Epub 2015 Jan 28.


Background: There is an epidemic of chronic kidney disease (CKD) of unknown etiology in Central American workers.

Objectives: To investigate changes and job-specific differences in kidney function over a 6-month sugarcane harvest season, explore the potential role of hydration, and measure proteinuria.

Methods: We recruited 284 Nicaraguan sugarcane workers performing seven distinct tasks. We measured urine albumin and serum creatinine and estimated glomerular filtration rate (eGFR).

Results: eGFR varied by job and decreased during the harvest in seed cutters (-8·6 ml/min/1·73 m(2)), irrigators (-7·4 ml/min/1·73 m(2)), and cane cutters (-5·0 ml/min/1·73 m(2)), as compared to factory workers. The number of years employed at the company was negatively associated with eGFR. Fewer than 5% of workers had albumin-to-creatinine ratio (ACR) >30 mg/g.

Conclusions: The decline in kidney function during the harvest and the differences by job category and employment duration provide evidence that one or more risk factors of CKD are occupational.

Keywords: Chronic kidney disease of nontraditional etiology,; Chronic kidney disease,; Estimated glomerular filtration rate,; Mesoamerican Nephropathy,; Serum creatinine,; Tubulointerstitial.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Albuminuria
  • Creatinine / blood
  • Farmers*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Kidney Diseases / blood
  • Kidney Diseases / epidemiology*
  • Kidney Diseases / physiopathology
  • Kidney Diseases / urine
  • Male
  • Middle Aged
  • Nicaragua / epidemiology
  • Occupational Diseases / blood
  • Occupational Diseases / epidemiology*
  • Occupational Diseases / physiopathology
  • Occupational Diseases / urine
  • Proteinuria / blood
  • Proteinuria / epidemiology*
  • Proteinuria / physiopathology
  • Proteinuria / urine
  • Saccharum*
  • Young Adult


  • Creatinine