Diagnostic role of urine specific gravity to detect kidney impairment on heat-exposed workers in a shoe factory in Indonesia: a cross-sectional study.
BMJ Open
; 11(9): e047328, 2021 09 29.
Article
in English
| MEDLINE | ID: covidwho-1443591
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 OUTCOMEMEASURES:
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.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Occupational Exposure
/
Heat Stress Disorders
/
Renal Insufficiency, Chronic
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Country/Region as subject:
Asia
Language:
English
Journal:
BMJ Open
Year:
2021
Document Type:
Article
Affiliation country:
Bmjopen-2020-047328
Similar
MEDLINE
...
LILACS
LIS