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Member Research & Reports

Member Research & Reports

BU Finds New Clues in Nicaraguan Kidney Disease Epidemic

The epidemic of kidney disease among young Central American agricultural workers may be the result of heat stress and volume depletion, according to new research led by the Boston University School of Public Health and published in the National Kidney Foundation’s American Journal of Kidney Diseases. The findings offer the latest clues about an epidemic that has led Nicaragua and El Salvador to have some of the highest age-adjusted mortality rates from kidney disease in the world.

For the study, researchers followed 284 sugar cane workers in seven different jobs from one company in northwestern Nicaragua. Blood and urine samples were collected from participants before and near the end of the six-month harvest season. Cane cutters—the workers who had the most labor-intensive jobs—had increased urinary NGAL and IL-18, both biomarkers of kidney injury.

“These individuals have the most physically strenuous jobs in a high-heat setting,” says lead author Dr. Rebecca Laws, a postdoctoral associate at BU. “They are also being paid by the amount they cut. It’s a system that can increase physical strain.

“At this point, we don’t know for certain that heat stress and volume depletion are causal, but we can say that electrolyte supplementation appears to reduce risks of kidney damage in occupations that expose workers to heat stress and volume depletion.”

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