Exposure of patients with chronic kidney disease on dialysis to pesticides

Quantitative and descriptive field research, with 90 patients with chronic kidney disease on dialysis in two hemodialysis units in the state of Santa Catarina, through the application of a structured questionnaire. Participants were divided into two groups: with and without exposure to pesticides. The questionnaire was applied in hemodialysis clinics during treatment. Laboratory test values were collected from clinical records. Data were analyzed using descriptive statistics and association using the chi-square test. For laboratory test data, a comparison of means was performed using the unpaired Student’s t-test between the groups.

Results:

The mean age of exposed participants was 58 years (±13.7; minimum = 23; maximum = 75) and that of non-exposed participants was 64 years old (±13.9; minimum = 35; maximum = 96). Of the 90 patients, 30% were exposed to pesticides. The mean exposure time was 6.7 ± 3.8 hours/day. There was a statistically significant association between the preparation of the mixture with pesticides and diabetes (p ≤ 0.048). There was no statistically significant difference between the results of laboratory tests in the exposed and non-exposed groups.

Conclusion:

This study shows that pesticides can be triggering factors for chronic kidney disease (CKD); however, we must expand research in this field to prove the relationship between exposure to pesticides and CKD.

Keywords:
Pesticides; Kidney Diseases; Life Style

Variables	n	%
Exposure to pesticides
Yes	27	30.0
No	63	70.0
TOTAL	90	100
Exposure to xenobiotic agents
Yes	23	25.6
No	67	74.4
TOTAL	90	100
Continuous use of medication
Yes	84	93.3
No	6	6.7
TOTAL	90	100
Comorbidities
Yes	81	90.0
No	9	10.0
TOTAL	90	100

Variables	n	%
Currently uses pesticides?
Yes	5	18.5
No	22	81.5
Currently prepares the syrup?
Yes	2	7.4
No	25	92.6
Ever prepared the syrup anytime in life?
Yes	9	33.3
No	16	59.3
Does not apply	2	7.4
Currently applies it?
Yes	3	11.1
No	24	88.9
Ever Applied during your life?
Yes	12	44.4
No	12	44.4
Does not apply	3	11.1
Place where the pesticide was prepared?
Garden/plantation	8	29.6
Dedicated shed	15	55.6
No defined place	1	3.7
Both	1	3.7
Other	2	7.4
Type of spraying?
Tractor	14	51.9
Backpack pump	8	29.6
Both	5	18.5
Application tractor has protective booth?
Yes	3	11.1
No	16	59.2
Does not apply	8	29.6
Owns PPE?
Yes	11	40.7
No	16	59.3
Wears PPE during syrup preparation?
Yes	10	37.0
No	17	63.0
Wears PPE during the application?
Yes	10	37.0
No	17	63.0
Variables	n	%
Follows order to wear PPE?
Yes	3	11.1
No	8	29.6
Has no PPE	16	59.2
Follows order to remove PPE?
Yes	3	11.1
No	8	29.6
Has no PPE	16	59.2
Underwear underneath the PPE has been wet by pesticides?
Yes	11	40.7
No	0	0.0
Has no PPE	16	59.3
When the underwear got wet, what did you do?
Continued the work, then changed it	8	29.6
Changed immediately	3	11.1
Has no PPE	16	59.3
Washes the PPE?
Yes	9	33.3
No	18	7.4
Has no PPE	16	59.3
Destination of the PPE underwear?
Changes and places together with the remaining dirt clothes	3	11.1
Washes separately	8	29.6
Does not have a PPE	16	59.3
Has meals near the place Where you handle the pesticide?
Yes	4	14.8
No	23	85.2
Smokes near the area of pesticide handling?
Yes	1	3.7
No	18	66.7
Does not smoke	8	29.6

Lab tests	Reference values¹1. Romão JE Jr. Doença renal crônica: definição, epidemiologia e classificação. J Bras Nefrol. 2004 [cited 2022 Feb 15];26(3 suppl):1-3. Available from: https://www.bjnephrology.org/article/doenca-renal-cronica-definicao-epidemiologia-e-classificacao/. https://www.bjnephrology.org/article/doe...	Exposed	Not exposed	p
Urea (mg/dL)	10 a 50	127.9 ± 6.02 (n = 24)	129.4 ± 4.82 (n = 39)	0.85
Creatinine (mg/dL)	0.6 a 1.10	7.9 ± 0.63 (n = 24)	6.6 ± 0.43 (n = 39)	0.07
Transaminase (U/L)	TGO up to 31 TGP up to 32	19.0 ± 2.75 (n = 22)	21.8 ± 3.50 (n = 39)	0.52
Potassium (mEq/L)	3.5 a 5.5	5.2 ± 0.15 (n = 23)	5.3 ± 0.13 (n = 39)	0.59
Calcium (mg/dL)	8.6 a 10.3	8.9 ± 0.28 (n = 24)	9.0 ± 0.11 (n = 38)	0.51
Phosphorus (mg/dL)	2.5 a 4.5	6.1 ± 0.46 (n = 24)	5.4 ± 0.23 (n = 39)	0.16

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[1] Correspondence to:
Lenita Agostinetto. E-mail: prof.leagostinetto@ uniplaclages.edu.br