Utility of Self-Reported Heat Stress Symptoms and NGAL Biomarker to Screen for Chronic Kidney Disease of Unknown Origin (CKDu) in Sri Lanka
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Measures
2.3. Laboratory Assessment of Urine Markers
2.4. Analyses
3. Results
3.1. Heat Stress Symptoms Were More Frequent in CKDu Endemic Regions
3.2. NGAL and CKDu Risk
4. Discussion
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Region | Date | CKDu Region and Occupation (n) | Villages (n) | Biomarkers |
---|---|---|---|---|
Anuradhapura District, Thanthirimale | May 2017 | Endemic Agricultural (190) Non-agricultural (28) | 3 | Urine SG Urine albumin Urine creatinine ACR |
Non-endemic Agricultural (39) | 1 | |||
Anuradhapura, Thanthirimale | May–August 2019 | Endemic Agricultural (75) Non-agricultural (67) | 3 | Urine SG Urine albumin Urine creatinine ACR Urine NGAL |
Hambanthota, Sooriyawewa | March 2020 | Non-endemic Agricultural (76) | 3 | Urine SG Urine albumin Urine creatinine ACR Urine NGAL |
Total Village Sample | ||||
Region | Endemic Region | Non-Endemic | ||
Occupation | Agricultural Workers (n = 288) | Non-Agricultural Workers (n = 67) | Agricultural Workers (n = 115) | p |
Demography | ||||
Female, % | 57.1 | 43.3 | 25.2 | <0.001 |
Age | 46.6 | 43.4 | 42.9 | 0.001 |
Health Conditions | ||||
CKD, % | 11.1 | 0.0 | 0.0 | <0.001 |
Diabetes, % | 5.2 | 10.5 | 3.5 | NS |
BMI | 23.4 | 23.4 | 22.2 | 0.014 |
Heat stress | 8.0 | 4.6 | 3.8 | <0.001 |
Water Intake | ||||
l/day | 2.7 | 2.1 | 2.1 | <0.001 |
NGAL Sub-Sample | ||||
Region | Endemic Region | Non-Endemic | ||
Occupation | Agricultural Workers (n = 71) | Non-Agricultural Workers (n = 67) | Agricultural Workers (n = 76) | p |
Demography | ||||
Female, % | 21.1 | 43.3 | 29.0 | 0.017 |
Age | 42.8 | 43.4 | 40.5 | NS |
Health Conditions | ||||
CKD, % | 7.1 | 0.0 | 0.0 | 0.005 |
Diabetes, % | 4.3 | 10.5 | 1.3 | 0.044 |
BMI | 21.9 | 23.4 | 22.0 | NS |
Heat stress | 5.4 | 4.6 | 2.8 | <0.001 |
Water Intake | ||||
l/day | 2.0 | 2.1 | 1.7 | <0.001 |
Urine Parameters | ||||
Specific gravity | 1.015 | 1.012 | 1.016 | 0.004 |
NGAL (se) | 52.9 (24.5) | 48.9 (13.3) | 17.5 (2.0) | NS |
Microalbumin (se) | 17.9 (5.4) | 13.5 (2.8) | 25.8 (6.1) | NS |
Creatinine (se) | 158.4 (14.3) | 107.0 (8.7) | 130.7 (8.2) | 0.007 |
ACR (se) | 26.9 (11.6) | 18.8 (3.9) | 26.6 (8.0) | NS |
Correlate | b | se | t | p | 95% CI |
---|---|---|---|---|---|
Constant | 6.89 | 2.86 | 2.41 | 0.02 | 1.26, 12.5 |
NGAL (morning sample) | 0.005 | 0.002 | 2.54 | 0.012 | 0.001, 0.008 |
Age | 0.004 | 0.023 | 0.18 | 0.86 | −0.04, 0.05 |
Gender (male) | −1.61 | 0.57 | 2.84 | 0.005 | −2.73, 0.49 |
Kidney disease | −1.67 | 1.71 | 0.97 | 0.33 | −5.05, 1.71 |
Diabetes | 2.83 | 1.22 | 2.33 | 0.02 | 0.43, 5.24 |
BMI | −0.01 | 0.06 | 0.16 | 0.87 | −0.13, 0.11 |
Sample | |||||
Agriculture–Endemic | Ref | ||||
Indoor–Endemic | −1.40 | 0.66 | 2.12 | 0.04 | −2.70, −0.10 |
Agriculture–Non-endemic | −2.62 | 0.63 | 4.15 | <0.001 | −3.87, −1.37 |
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Kulasooriya, P.N.; Jayasekara, K.B.; Nisansala, T.; Kannangara, S.; Karunarathna, R.; Karunarathne, C.; Wikramarathne, M.; Albert, S.M. Utility of Self-Reported Heat Stress Symptoms and NGAL Biomarker to Screen for Chronic Kidney Disease of Unknown Origin (CKDu) in Sri Lanka. Int. J. Environ. Res. Public Health 2021, 18, 10498. https://doi.org/10.3390/ijerph181910498
Kulasooriya PN, Jayasekara KB, Nisansala T, Kannangara S, Karunarathna R, Karunarathne C, Wikramarathne M, Albert SM. Utility of Self-Reported Heat Stress Symptoms and NGAL Biomarker to Screen for Chronic Kidney Disease of Unknown Origin (CKDu) in Sri Lanka. International Journal of Environmental Research and Public Health. 2021; 18(19):10498. https://doi.org/10.3390/ijerph181910498
Chicago/Turabian StyleKulasooriya, Pavithra N., Kithsiri B. Jayasekara, Thilini Nisansala, Sajani Kannangara, Ranawaka Karunarathna, Chaminda Karunarathne, Mahinda Wikramarathne, and Steven M. Albert. 2021. "Utility of Self-Reported Heat Stress Symptoms and NGAL Biomarker to Screen for Chronic Kidney Disease of Unknown Origin (CKDu) in Sri Lanka" International Journal of Environmental Research and Public Health 18, no. 19: 10498. https://doi.org/10.3390/ijerph181910498