Abstract
Chronic kidney disease of unknown origin (CKDu) is an epidemic that has resulted in tens of thousands of deaths among workers in Latin America.1 It has been hypothesized that work, especially among sugarcane harvesters, contributes to the progression of disease through recurrent clinical and subclinical acute kidney injury.2-5 In a previous study, we observed that among the same cohort of Guatemalan sugarcane harvesters, subgroups experienced differing degrees of daily changes in creatinine. Workers with the largest daily fluctuations experienced the greatest decline in renal function by the end of the harvest season.
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