TY - JOUR T1 - Markers of kidney tubular and interstitial injury and function among sugarcane workers with cross-harvest serum creatinine elevation JF - Occupational and Environmental Medicine JO - Occup Environ Med SP - 396 LP - 402 DO - 10.1136/oemed-2021-107989 VL - 79 IS - 6 AU - Erik Hansson AU - David H Wegman AU - Catharina Wesseling AU - Jason Glaser AU - Zachary J Schlader AU - Julia Wijkström AU - Kristina Jakobsson Y1 - 2022/06/01 UR - http://oem.bmj.com/content/79/6/396.abstract N2 - Objectives Serum creatinine (SCr) is a routine marker of kidney injury but also increases with dehydration and muscular work. This study was to elucidate whether increase in SCr is associated with more specific markers of kidney tubular and interstitial injury and function, during prolonged heat stress among workers at high risk of chronic kidney disease of non-traditional origin (CKDnt).Methods Urine monocyte chemoattractant protein-1 (MCP-1), kidney injury molecule-1 (KIM-1), calbindin, glutathione S-transferase-π (GST-π), clusterin, interleukin 18 and albumin, fractional excretion of potassium (FEK), blood haemoglobin, serum potassium, ferritin and erythropoietin were measured before and after harvest in a sample of 30 workers with a ≥0.3 mg/dL SCr increase across harvest (cases), and 53 workers with stable SCr (controls).Results Urine MCP-1 (p for differential cross-harvest trend <0.001), KIM-1 (p=0.002), calbindin (p=0.02), GST-π (p=0.04), albumin (p=0.001) and FEK (p<0.001) increased in cases, whereas blood haemoglobin (p<0.001) and serum erythropoietin (p<0.001) decreased.Conclusion Several markers of tubular and interstitial injury and function changed as SCr increased across a harvest season, supporting the use of SCr as an indicator of kidney injury in physically active workers regularly exposed to heat stress. Repeated injury similar to that described here, and continued work under strenuous and hot conditions with similarly elevated injury markers is likely to worsen and possibly initiate CKDnt.Data are available upon reasonable request. ER -