Abstract

Chronic kidney disease of unknown etiology (CKDu) has emerged agricultural population. This study aimed to obtain a prevalence of cholinesterase activity and CKDu, and evaluate factors associated with organophosphate (OP) and carbamate (CA) poisoning and CKDu among farmers in Nakhon Ratchasima province, Thailand. A cross-sectional study was conducted among 58 farmers, with data collected using a structured questionnaire. Blood and urine samples were collected for analysis of erythrocyte acetylcholinesterase (AChE), butyrylcholinesterase (BuChE), serum creatinine (SCr), and urinary creatinine (UCr). Farmers who had CKD without diabetes, hypertension, proteinurea, and other traditional causes were classified as CKDu. The average age (± SD) was 49.22(± 6.87) years. The prevalence of abnormal AChE and BuChE activity levels were 55.17% and 46.55%, respectively. In kidney function, the prevalence of abnormal UCr was 17.24% and CKDu was 24.14%. In adjusted model, the type of pesticide sprayer and personal protective equipment used were significantly associated with CKDu (bivariate analysis, p < 0.05). Using multivariate analysis, OP and CA poisoning were significantly associated with a 4.703-fold higher risk of CKDu (95% CI = 1.020-21.686). Farmers who applied OP and CA pesticides had decreased kidney function. These findings might be beneficial in reducing the adverse effects pesticide exposure and CKDu prevention.

摘要

不明原因的慢性肾病（CKDu）已出现在农业人群中。本研究旨在了解泰国呵叻府农民中胆碱酯酶活性和 CKDu 的流行情况，并评估与有机磷 (OP) 和氨基甲酸酯 (CA) 中毒和 CKDu 相关的因素。对 58 名农民进行了横断面研究，数据使用结构化问卷收集。收集血液和尿液样本用于分析红细胞乙酰胆碱酯酶 (AChE)、丁酰胆碱酯酶 (BuChE)、血清肌酐 (SCr) 和尿肌酐 (UCr)。没有糖尿病、高血压、蛋白尿和其他传统原因的 CKD 的农民被归类为 CKDu。平均年龄 (± SD) 为 49.22(± 6.87) 岁。异常 AChE 和 BuChE 活性水平的患病率分别为 55.17% 和 46.55%，分别。在肾功能方面，UCr 异常发生率为 17.24%，CKDu 为 24.14%。在调整后的模型中，使用的农药喷雾器和个人防护装备的类型与 CKDu 显着相关（双变量分析，p  < 0.05)。使用多变量分析，OP 和 CA 中毒与 CKDu 高 4.703 倍的风险显着相关（95% CI = 1.020-21.686）。使用 OP 和 CA 农药的农民肾功能下降。这些发现可能有助于减少农药暴露和 CKDu 预防的不利影响。