Can your work affect your kidney's health?

Global disease burden attributable to kidney dysfunction, 1990-2019: A health inequality and trend analysis based on the global burden of disease study

OBJECTIVE

This study aimed to evaluate the burden of kidney dysfunction (KD), assess socioeconomic inequalities, and project trends in the future.

METHODS

Data on deaths, disability-adjusted life years (DALYs), years lived with disability (YLDs), and years of life lost (YLLs) were from Global Burden of Disease Study 2019. The Joinpoint regression model was utilized to analyze the temporal trend by the annual percentage change (APC). The slope index and concentration index were employed to evaluate cross-country disparities. The future trend was predicted using an age-period-cohort analysis.

RESULTS

In the past three decades, the death numbers of KD increased from 1,571,720 to 3,161,552, DALYs from 42,090,331 to 76,486,945, YLDs from 5,003,267 to 11,282,484, and YLLs from 37,087,065 to 65,204,461, respectively. The age-standardized rate (ASR) of deaths, DALYs, and YLLs exhibited a declining trend. The ASR of YLDs increased until 2017, then decreased. The slope index and concentration index for DALYs increased from 248.1 to 351.9 and from 40.70 to 57.8. In the future, the ASR of deaths, DALYs, YLDs, and YLLs will remain stable, while their numbers will continue to rise, except for YLLs.

CONCLUSIONS

The disease burden of KD remained serious. Tailored interventions should be developed based on national contexts.

The impact of heat on kidney health: A PRISMA-compliant bibliometric analysis

BACKGROUND

Exposure to excessive heat can impact kidney health. Climate change is projected to aggravate this impact. An analysis of articles published between 1958 and 2021 was conducted to explore the progress of the research on this issue.

METHODS

This study included a bibliometric analysis wherein Web of Science was used to generate a list of all published articles related to the impact of heat on kidney health. Basic information about the articles, such as titles, authors' names, keywords, and citations, were recorded and analyzed.

RESULTS

A total of 226 published articles related to the impact of heat on kidney health were identified as of November 20, 2021. Most of these articles (93%) were published within the last decade. The United States was the most prominent country in terms of research productivity and collaboration. Researchers from the United States were well represented among the top 20 contributors of published articles on the study issue. The productivity of the top 20 authors varied between 6 and 32 articles each. A total of 25 common words used by the authors were identified. The most frequently used keywords were chronic kidney disease, heat stress, acute kidney injury, Mesoamerican nephropathy, and climate change. Keyword analysis revealed 3 distinct major research clusters in the existing scientific research on the impact of heat on kidney health: chronic kidney disease of unknown etiology, heat stress and renal physiology, and the effect of climate change on kidney health.

CONCLUSIONS

Research on heat-related kidney injury has witnessed rapid development in recent decades, motivated by the emergence of chronic kidney disease of unknown etiology and climate change. Developing countries in hot regions must increase their productivity in this research area through international collaboration and partnerships.

Female nurses have a higher prevalence of urinary tract symptoms and infection than other occupations in dialysis units

Introduction:

Urinary tract symptoms and infection have been associated with occupational factors that impact hydration habits particularly in women. We compared self-reported urinary symptoms and infection and hydration habits between nurses and other occupations in dialysis units.

Methods:

Cross-sectional study. Participants worked in five nephrology centers in Brazil and answered an online questionnaire comprising questions regarding urinary tract symptoms and infection episodes in the preceding year; data on usual daily beverage intake, urine frequency, and urine color according to a urine color chart were also collected, as well as perceptions of water access and toilet adequacy at work.

Results:

We included 133 women (age=36.9±9.5 years). The self-reported usual daily beverage intake was 6.6±2.9 cups/day (~1320 mL), daily urine frequency was 5.4±2.1, and urine color chart score: 3.0±1.2. Nurses (N=66/49.6%) reported higher prevalence of burning sensation (50 versus 27%; P<0.001), urinary urgency (42 versus 21%; P<0.001), and infection (42% versus 25%; P=0.04) as well as lower liquid intake (6.0±2.6 versus 7.3±3.0 cups/day; P=0.01) than controls. Forty four percent of nurses reported being able to drink when thirsty "always" and "most of the time" versus 93% of the control group.

Conclusion:

Dialysis female nurses reported lower beverage intake and higher prevalence of symptoms and infection than other occupations in the same environment. Interventions to improve hydration can potentially decrease urinary problems in this population.

Health vs. wealth: Employer, employee and policy-maker perspectives on occupational heat stress across multiple European industries

Successful implementation of cooling strategies obviously depends on identifying effective interventions, but in industrial settings, it is equally important to consider feasibility and economic viability. Many cooling interventions are available, but the decision processes affecting adoption by end-users are not well elucidated. We therefore arranged two series of meetings with stakeholders to identify knowledge gaps, receive feedback on proposed cooling interventions, and discuss factors affecting implementation of heat-health interventions. This included four meetings attended by employers, employees, and health and safety officers (n = 41), and three meetings attended primarily by policy makers (n = 74), with feedback obtained via qualitative and quantitative questionnaires and focus group discussions. On a 10-point scale, both employers and employees valued worker safety (9.1 ± 1.8; mean±SD) and health (8.5 ± 1.9) as more important than protecting company profits (6.3 ± 2.3). Of the respondents, 41% were unaware of any cooling strategies at their company and of those who were aware, only 30% thought the interventions were effective. Following presentation of proposed interventions, the respondents rated "facilitated hydration", "optimization of clothing/protective equipment", and "rescheduling of work tasks" as the top-three preferred solutions. The main barriers for adopting cooling interventions were cost, feasibility, employer perceptions, and legislation. In conclusion, preventing negative health and safety effects was deemed to be more important than preventing productivity loss. Regardless of work sector or occupation, both health and wealth were emphasized as important parameters and considered as somewhat interrelated. However, a large fraction of the European worker force lacks information on effective measures to mitigate occupational heat stress. List of abbreviations: OH-Stress: Occupational heat stress; WBGT: Wet Bulb Globe Temperature.

Sustainable Development Goals relevant to kidney health: an update on progress

Globally, more than 5 million people die annually from lack of access to critical treatments for kidney disease — by 2040, chronic kidney disease is projected to be the fifth leading cause of death worldwide. Kidney diseases are particularly challenging to tackle because they are pathologically diverse and are often asymptomatic. As such, kidney disease is often diagnosed late, and the global burden of kidney disease continues to be underappreciated. When kidney disease is not detected and treated early, patient care requires specialized resources that drive up cost, place many people at risk of catastrophic health expenditure and pose high opportunity costs for health systems. Prevention of kidney disease is highly cost-effective but requires a multisectoral holistic approach. Each Sustainable Development Goal (SDG) has the potential to impact kidney disease risk or improve early diagnosis and treatment, and thus reduce the need for high-cost care. All countries have agreed to strive to achieve the SDGs, but progress is disjointed and uneven among and within countries. The six SDG Transformations framework can be used to examine SDGs with relevance to kidney health that require attention and reveal inter-linkages among the SDGs that should accelerate progress.

Working towards sustainable development is essential to tackle the rise in the global burden of non-communicable diseases, including kidney disease. Five years after the Sustainable Development Goal agenda was set, this Review examines the progress thus far, highlighting future challenges and opportunities, and explores the implications for kidney disease.

Each Sustainable Development Goal (SDG) has the potential to improve kidney health and prevent kidney disease by improving the general health and well-being of individuals and societies, and by protecting the environment.

Achievement of each SDG is interrelated to the achievement of multiple other SDGs; therefore, a multisectoral approach is required.

The global burden of kidney disease has been relatively underestimated because of a lack of data.

Structural violence and the social determinants of health have an important impact on kidney disease risk.

Kidney disease is the leading global cause of catastrophic health expenditure, in part because of the high costs of kidney replacement therapy.

Achievement of universal health coverage is the minimum requirement to ensure sustainable and affordable access to early detection and quality treatment of kidney disease and/or its risk factors, which should translate to a reduction in the burden of kidney failure in the future.

Risk of Kidney Injury among Construction Workers Exposed to Heat Stress: A Longitudinal Study from Saudi Arabia

Saudi Arabia (SA) is one of the hottest countries in the world. This study was conducted to assess the impact of summer heat stress in Southeastern SA on short-term kidney injury (KI) among building construction workers and to identify relevant risk factors. Measurements of urinary albumin-creatinine ratio (ACR), height, weight, hydration, symptoms, daily work and behavioral factors were collected in June and September of 2016 from a cohort of construction workers (n = 65) in Al-Ahsa Province, SA. KI was defined as ACR ≥ 30 mg/g. Multivariate linear regression analysis was used to assess factors related to cross-summer changes in ACR. A significant increase in ACR occurred among most workers over the study period; incidence of KI was 18%. Risk factors associated with an increased ACR included dehydration, short sleep, and obesity. The findings suggest that exposure to summer heat may lead to the development of KI among construction workers in this region. Adequate hydration and promotion of healthy habits among workers may help reduce the risk of KI. A reduction in work hours may be the most effective intervention because this action can reduce heat exposure and improve sleep quality.