A pilot study of urinary biomarkers and kidney injury among agricultural workers

Chronic kidney disease of unknown origin (CKDu), also referred to as Mesoamerican nephropathy, is a significant public health problem for farming communities. In this exploratory pilot study, we evaluated a recently developed panel of 21 different urinary protein biomarkers of kidney injury and disease among sugarcane workers in a CKDu-endemic region of Guatemala. We also examined potential biomarkers of acute kidney injury from pre-shift and post-shift to explore indicators of acute kidney stress and reduced kidney function. Several biomarkers including retinol binding protein 4, monocyte chemoattractant protein-1, clusterin, neutrophil gelatinase-associated lipocalin, and β2-microglobulin were significantly elevated (false discovery rate < 0.1) among participants with reduced kidney function measured in pre-shift urine samples. Taken together, the findings from this pilot study highlight the potential utility of urinary protein biomarkers for the earlier detection of kidney injury and CKDu risk. However, further validation in larger cohorts is warranted.