Pesticide-induced changes in cholinesterase activity and chronic kidney disease of unknown etiology among farmers in Nakhon Ratchasima, Thailand

Abstract

Chronic kidney disease of unknown etiology (CKDu) has emerged agricultural population. This study aimed to obtain a prevalence of cholinesterase activity and CKDu, and evaluate factors associated with organophosphate (OP) and carbamate (CA) poisoning and CKDu among farmers in Nakhon Ratchasima province, Thailand. A cross-sectional study was conducted among 58 farmers, with data collected using a structured questionnaire. Blood and urine samples were collected for analysis of erythrocyte acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), serum creatinine (SCr), and urinary creatinine (UCr). Farmers who had CKD without diabetes, hypertension, proteinurea, and other traditional causes were classified as CKDu. The average age (± SD) was 49.22(± 6.87) years. The prevalence of abnormal AChE and BuChE activity levels were 55.17% and 46.55%, respectively. In kidney function, the prevalence of abnormal UCr was 17.24% and CKDu was 24.14%. In adjusted model, the type of pesticide sprayer and personal protective equipment used were significantly associated with CKDu (bivariate analysis, p < 0.05). Using multivariate analysis, OP and CA poisoning were significantly associated with a 4.703-fold higher risk of CKDu (95% CI = 1.020-21.686). Farmers who applied OP and CA pesticides had decreased kidney function. These findings might be beneficial in reducing the adverse effects pesticide exposure and CKDu prevention.