Kidney Week

Abstract: SA-PO0316

Heat Exposure and Kidney Dysfunction in US Farmworkers

Session Information

• AKI: Epidemiology and Risk Factors
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Briones Jimenez, Oscar Hazael, Duke Global Health Institute, Duke University, Durham, North Carolina, United States

Oscar Hazael Briones Jimenez, MS

• Carrion, Veronica M., Duke Hubert-Yeargan Center for Global Health, Duke University, Durham, North Carolina, United States

Veronica M. Carrion, MD

• Lormendez, Vidal, NC FIELD, Inc., Kinston, North Carolina, United States

Vidal Lormendez

• Agi Maluli, Isabela, Anne Burnett Marion School of Medicine at Texas Christian University, Fort Worth, Texas, United States

Isabela Agi Maluli

• Bhati, Isabel J., Duke University Trinity College of Arts and Sciences, Durham, North Carolina, United States

Isabel J. Bhati

• M Rojo, Elizabeth, Duke University School of Medicine, Durham, North Carolina, United States

Elizabeth M Rojo

• Cuello, Yesenia, NC FIELD, Inc., Kinston, North Carolina, United States

Yesenia Cuello

• Castillo, Melissa, NC FIELD, Inc., Kinston, North Carolina, United States

Melissa Castillo

• Harishchandra, Akila, Faculty of Technology, Rajarata University of Sri Lanka, Mihintale, Sri Lanka

Akila Harishchandra, PhD

• Wyatt, Christina M., Duke University School of Medicine, Durham, North Carolina, United States

Christina M. Wyatt, MD

• Jayasundara, Nishad, Duke University Nicholas School of the Environment, Durham, North Carolina, United States

Nishad Jayasundara, PhD

• Strasma, Anna, Duke Global Health Institute, Duke University, Durham, North Carolina, United States

Anna Strasma, MD

Background

Excessive occupational heat affects billions of workers and disproportionately harms agricultural workers worldwide, yet most states, including North Carolina, lack occupational heat regulations. A key gap is linking climate exposure, physiologic heat stress, and kidney outcomes. This pilot combines core body temperature (CBT) monitoring, climate assessment, and repeated biospecimen.

Methods

This community-engaged study took place with four separate cohorts in August 2025, including 20 male farmworkers in eastern NC. Participants completed two study visits: Visit 1 on the afternoon of a nonwork day and Visit 2 in the evening after four consecutive workdays. At both visits, surveys and urine/blood samples were collected to assess eGFR using creatinine- and cystatin C. Kidney dysfunction was defined as cystatin C eGFR <90 or UACR >30 mg/g. Between visits, CBT and heart rate were monitored, and ERA5 climate data were used to evaluate hourly Heat Index and WBGT.

Results

Biomarkers key findings: Median eGFR decreased from V1 to V2 using both creatinine- and cystatin C-based equations, with a larger and statistically significant decline observed using the cystatin C equation: median eGFR decreased from 107 at V1 to 92 mL/min/1.73 m2 at V2, with a median change of -6.0 (p = 0.003). No participants had eGFR <60. Using the Cystatin C equation for eGFR, 6/20 (30%) of workers had an eGFR from 60–90 mL/min/1.73 m2 at both visits. One participant had an AKI from V1 to V2, and one had >1g proteinuria at both visits.

Conclusion

This pilot shows feasible integration of CBT monitoring, climate data, and biospecimens, identifying high heat exposure and 30% kidney dysfunction in young U.S. farmworkers.

Figure 1: Summary measures of core body temperature and climatic metrics by kidney dysfunction status

Funding

• Private Foundation Support