POS-002 ACUTE KIDNEY INJURY (AKI) IN RURAL WORKERS: SHOULD WE TALK ABOUT AGRICULTURAL NEPHROPATY INSTEAD OF MESOAMERICAN NEPHROPATY?

Abstract

Mesoamerican nephropathy (MN) is a chronic tubule-interstitial nephropathy, originally described in Central America, and whose etiology is still unknown. Among its many proposed inducing factors are severe dehydration, rhabdomyolysis, nephrotoxicity, chronic infections, genetic predisposition, etc. However, clinical cases similar to MN have been described in other geographically distant and ethnically diverse regions which have a common factor: the intensity of heat and rural physical labor. For this reason, we suggest the term “agricultural nephropathy” as more appropriate name for this condition. Then, it was decided to study whether this entity could occur among rural workers in a non Mesoamerican region but having similar climatic and working conditions, in the Colombian Caribbean countryside, and to consider how much repeated dehydration could weigh in its pathogenesis. A descriptive, observational, crosssectional study was carried out, based on field work in a farm in Sitio Nuevo (Magdalena, Colombia) in 28 rural worker volunteers (rice fields), who were measured for weight, blood pressure, blood and urine samples to measure electrolytes and osmolarity, at 2 times of the day (morning and evening Of the 28 young men workers evaluated, 5 (18%) presented a significant increase in serum creatinine during the day (0.8±0.15 vs 1.2±0.17, p: <0.001). The volume of water ingested by the workers was highly variable (2,861 ± 1,591 cc). There was a significant increase in serum sodium (p: <0.001), and urinary osmolarity (p: 0.01) values between morning and afternoon values in these 5 patients Eighteen percent of the workers evaluated developed parameters compatible with AKI and dehydration during the work day in the Colombian Caribbean countryside