Association between the use of agricultural chemicals and the development of idiopathic chronic kidney disease in hemodialysis patients from four clinics in Guayas.

Abstract

Introduction: Chronic kidney disease of non-traditional etiology (CKDnt) represents a growing problem in agricultural populations exposed to environmental and chemical factors. Prolonged exposure to agrochemicals has been proposed as a possible risk factor for the development of CKDnt, although the association has not yet been fully established.

Materials and Methods: An observational, retrospective, longitudinal cohort, and analytical study was conducted across four dialysis centers. A total of 882 hemodialysis patients were included; of these, 295 met the inclusion criteria and had a diagnosis of CKDnt. Sociodemographic variables, occupational history, and exposure to agricultural chemicals were analyzed. The association between exposure and CKDnt was evaluated using the Odds Ratio (OR) and 95% confidence interval (CI), with a statistical significance level of p<0.05.

Results: Patients exposed to chemicals were predominantly male (93%), rural residents (80%), and farmers prior to starting dialysis (88%). In this group, CKDnt was the most frequent etiology (45%). Among the non-exposed group, type 2 diabetes mellitus predominated (33%). Of the patients with CKDnt, 67% were farmers and 76% resided in rural areas. Ninety-seven percent of the exposed patients had more than 10 years of exposure. Bivariate analysis showed that exposure to agricultural chemicals increases the risk of CKDnt (OR=260; 95% CI: 256.64–6186.07; p<0.001) and that exposure lasting 10 years or more increases the risk (OR=416; 95% CI: 135.99–1273.65; p<0.001).

Conclusiones: Existe una asociación significativa entre la exposición prolongada a químicos agrícolas y el desarrollo de ERCI en pacientes hemodializados, especialmente en trabajadores agrícolas con más de 10 años de exposición. La exposición prolongada, la falta de uso de medidas de bioseguridad; determinan escenarios sombríos para esta población. Estos hallazgos respaldan la necesidad de estrategias preventivas en poblaciones rurales expuestas.