Prevalence and Risk Factors for the Detection of Environmental Nephropathy in the Colombian Caribbean

Objective. To evaluate the acute cross-shift changes in renal function and occupational risk factors associated with environmental nephropathy among rural workers in the Colombian Caribbean. Material and Method. An observational, cross-sectional analytical study was conducted with a community-based sample of 78 active rural workers (48 agricultural and 30 construction workers). Variables analyzed included sociodemographic characteristics, toxic habits, agrochemical exposure, fluid intake, and clinical parameters. Blood and urine samples were collected pre- and post-shift. A multivariable linear regression model was constructed to identify independent predictors of the acute cross-shift decline in estimated glomerular filtration rate (ΔeGFR). Results. The cohort was highly exposed to adverse occupational conditions, including prolonged workdays (69% worked > 48 hours per week) and insufficient hydration (79% consumed < 3 liters of fluid daily). Post-shift analysis revealed significant acute physiological stress, including a significant decline in overall eGFR (p < 0.001) and acute increases in urinary specific gravity, incident proteinuria (p=0.008), and leukocyturia (p<0.001). Notably, incident hematuria increased significantly across the workday exclusively among agricultural workers (21% to 40%, p = 0.02). Multivariable analysis identified occupational exposure to herbicides (β = -16, p = 0.014) and active smoking status (β = -12, p = 0.016) as the strongest independent predictors of acute cross-shift renal function loss. Conclusion. Workers under adverse environmental conditions in the Colombian Caribbean experience severe acute cross-shift declines in renal function and markers of acute tubular injury, driven by heavy labor, heat stress, and herbicide exposure.