Jaime Butler-Dawson1,2,3, Miranda Dally4,5,6, Richard J Johnson6,7, Evan C Johnson8, Lyndsay Krisher4,6, Laura-Gabriela Sánchez-Lozada9, Benjamin R Griffin7, Stephen Brindley5, Lee S Newman4,5,6,10,11. 1. Center for Health, Work, and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA, jaime.butler-dawson@cuanschutz.edu. 2. Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA, jaime.butler-dawson@cuanschutz.edu. 3. Colorado Consortium on Climate Change and Human Health, University of Colorado, Aurora, Colorado, USA, jaime.butler-dawson@cuanschutz.edu. 4. Center for Health, Work, and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA. 5. Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA. 6. Colorado Consortium on Climate Change and Human Health, University of Colorado, Aurora, Colorado, USA. 7. Division of Renal Diseases and Hypertension, Department of Medicine, School of Medicine, University of Colorado, Aurora, Colorado, USA. 8. Division of Kinesiology and Health, University of Wyoming, Laramie, Wyoming, USA. 9. Department of Cardio-Renal Physiopathology, Instituto Nacional de Cardiología-Ignacio Chávez, Mexico City, Mexico. 10. Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, School of Medicine, Aurora, Colorado, USA. 11. Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA.
Abstract
BACKGROUND: Vasopressin is elevated in response to heat and dehydration and has been postulated to have a role in the chronic kidney disease of unknown origin being observed in Central America. The aims of this study were to examine whether the vasopressin pathway, as measured by copeptin, is associated with the presence of kidney dysfunction, and to examine whether higher fluid intake is associated with lower circulating copeptin and thereby preserves kidney health among sugarcane workers exposed to hot conditions. METHODS: Utilizing a longitudinal study of 105 workers in Guatemala, we examined relationships between hydration indices, plasma copeptin concentrations, and kidney function markers at 3 times during the 6-month harvest. We also examined whether baseline copeptin concentrations increased the odds of developing an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. RESULTS: Copeptin concentrations were positively associated with serum creatinine (β 1.41, 95% CI 0.88-2.03) and negatively associated with eGFR (β -1.07, 95% CI -1.43 to -0.70). In addition, as workers improved their hydration (measured by increases in fluid balance), copeptin concentrations were reduced, and this reduction was associated with an improvement in kidney function. CONCLUSIONS: Results suggest that copeptin should be studied as a potential prognostic biomarker.
BACKGROUND:Vasopressin is elevated in response to heat and dehydration and has been postulated to have a role in the chronic kidney disease of unknown origin being observed in Central America. The aims of this study were to examine whether the vasopressin pathway, as measured by copeptin, is associated with the presence of kidney dysfunction, and to examine whether higher fluid intake is associated with lower circulating copeptin and thereby preserves kidney health among sugarcane workers exposed to hot conditions. METHODS: Utilizing a longitudinal study of 105 workers in Guatemala, we examined relationships between hydration indices, plasma copeptin concentrations, and kidney function markers at 3 times during the 6-month harvest. We also examined whether baseline copeptin concentrations increased the odds of developing an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. RESULTS:Copeptin concentrations were positively associated with serum creatinine (β 1.41, 95% CI 0.88-2.03) and negatively associated with eGFR (β -1.07, 95% CI -1.43 to -0.70). In addition, as workers improved their hydration (measured by increases in fluid balance), copeptin concentrations were reduced, and this reduction was associated with an improvement in kidney function. CONCLUSIONS: Results suggest that copeptin should be studied as a potential prognostic biomarker.
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