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. 2022 May;32(3):461-471.
doi: 10.1038/s41370-021-00292-x. Epub 2021 Feb 18.

Environmental metal exposures and kidney function of Guatemalan sugarcane workers

Jaime Butler-Dawson  1   2   3 , Katherine A James  4   5   6 , Lyndsay Krisher  4   5   6 , Diana Jaramillo  4   6 , Miranda Dally  4   5   6 , Natalie Neumann  7   8 , Daniel Pilloni  9 , Alex Cruz  9 , Claudia Asensio  9 , Richard J Johnson  6   10 , John Adgate  4   5 , Lee S Newman  4   5   6   11   12
Affiliations

Environmental metal exposures and kidney function of Guatemalan sugarcane workers

Jaime Butler-Dawson et al. J Expo Sci Environ Epidemiol. 2022 May.

Abstract

Background: Exposure to environmental metals can cause nephrotoxicity. There is an international epidemic of chronic kidney disease of unknown cause (CKDu). Whether metal exposures contribute to kidney dysfunction in populations at risk for CKDu remains unresolved.

Objective: Urinary metals (arsenic, cadmium, nickel, and uranium) were examined in 222 sugarcane cutters in Guatemala at three time points over 1 year.

Methods: We explored the relationships between metal concentrations and markers of kidney function using multivariable linear mixed-effect models.

Results: Arsenic, cadmium, and nickel were detected in the majority of the 340 urine samples and were generally within limits previously considered to be nonnephrotoxic. Nevertheless, higher urine cadmium was inversely associated with estimated glomerular filtration rate (eGFR) (β: -4.23, 95% confidence interval [CI]: -6.92, -1.54) and positively associated with neutrophil gelatinase-associated lipocalin (NGAL) (β: 2.92, 95% CI: 1.20, 4.64). Higher urine arsenic was also inversely associated with eGFR (β: -4.36, 95% CI: -7.07, -1.64).

Significance: Our findings suggest that exposures to metals, including cadmium and arsenic, might contribute to kidney toxicity seen in workers at risk for CKDu. These findings are consistent with the potential for metal nephrotoxicity at lower than expected levels in the setting of manual work in a very hot environment.

Keywords: Agricultural workers; Kidney function; Metal exposure.

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Conflict of interest statement

Conflict of Interests: The University of Colorado has a memorandum of agreement with Pantaleon, a Guatemala-based agribusiness. Pantaleon provides partial financial support for research through a contract with the university and has provided access to the employees who volunteered to participate in this research project. The University of Colorado employed appropriate research methods in keeping with academic freedom, based conclusions on critical analysis of the evidence and reported findings fully and objectively. The terms of this arrangement have been reviewed and approved by the University of Colorado in accordance with its conflict of interest policies.

Figures

Figure 1:
Figure 1:
Study timeline and design. Abbreviations: As: arsenic; Cd: Cadmium; Ni: Nickel; NGAL: urine neutrophil gelatinase-associated lipocalin; ACR: urine albumin-to-creatinine ratio; Cr: capillary blood creatinine.
See this image and copyright information in PMC

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