AI Article Synopsis
- The study investigates kidney damage in indoor heat-exposed workers at a shoe-making factory in West Java, Indonesia, focusing on the potential of urine specific gravity as a predictive measure for kidney injury.
- A total of 119 healthy subjects were analyzed, where a small percentage showed decreased kidney function and signs of kidney injury despite generally preserved renal function.
- Findings revealed that a urine specific gravity cut-off of ≥1.018 effectively predicts increased urinary nephrin levels, indicating potential kidney damage in these workers.
Article Abstract
Objectives: Globally, there are increasing cases of chronic kidney disease of unknown origin among heat-exposed workers. We aimed to see the kidney damages of indoor heat-exposed workers and whether urine specific gravity can predict any kidney damages.
Design: A cross-sectional study.
Setting: A shoe-making factory in West Java, Indonesia.
Participants: 119 subjects were included. Minimum total sample size was 62. Subjects were indoor heat-exposed workers who were exposed to occupational wet-bulb globe temperature (WBGT) of 28°C-30°C for 8 hours daily with 1 hour break, 5 days a week. The inclusion criterion was healthy subjects according to the result from annual medical check-up in 2019. The exclusion criteria were subjects who were taking vitamins and/or supplements that might cause disturbance in urine specific gravity and/or hydration status, pregnant and fasting.
Primary And Secondary Outcome Measures: Area under the curve (AUC), sensitivity and specificity of urine specific gravity for the detection of urinary nephrin and urinary kidney injury molecule-1 (KIM-1) were analysed. Estimated glomerular filtration rate (eGFR) and quantitative albuminuria were also measured.
Results: WBGT in the work area of the subject was 28°C-30°C. There were 15 (12.6%) subjects who had eGFR <90 mL/min, but ≥60 mL/min. High serum vasopressin levels were found in 79 subjects with a mean of 6.54 (95% CI 5.94 to 7.14) ng/mL. Most subjects had nephrinuria (87.4%) with preserved renal function (87.4%). Several subjects had elevated urinary KIM-1 (10.9%) and albuminuria (7.6%). AUC of urine specific gravity for increased urinary nephrin was 81.7% (95% CI 68.8% to 94.6%) and statistically significant (p<0.001). Cut-off value of ≥1.018 for urine specific gravity has sensitivity of 71.2% and specificity of 80% for detecting elevation of urinary nephrin levels.
Conclusion: Urine specific gravity with a cut-off value of ≥1.018 could be used to detect nephrinuria among heat-exposed workers.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8483020 | PMC |
| http://dx.doi.org/10.1136/bmjopen-2020-047328 | DOI Listing |
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