Thesis (M.S.)--University of Alabama at Birmingham, 2006. / Title from first page of PDF file (viewed on June 30, 2007). Includes bibliographical references (p. 69-73).

Crianças pequenas representam um grupo desafiador no transplante renal. O estudo analisa os resultados, do ponto de vista cirúrgico, do transplante renal em crianças com peso inferior a 15 kg utilizando o acesso cirúrgico extraperitoneal. Métodos: Foram revisados retrospectivamente os prontuários de 62 crianças com peso inferior a 15 kg submetidas a transplante renal entre 1998 e 2010, utilizando o acesso extraperitoneal e anastomose dos vasos renais dos doadores com a aorta ou artéria ilíaca comum e com a veia cava inferior ou ilíaca comum dos receptores. O ureter foi anastomosado à bexiga pela técnica extravesical de Lich- Grégoir. Resultados: Dos 62 transplantes, 32 enxertos (51,6%) eram provenientes de doadores vivos e 30 (48,4%) de doadores falecidos, sendo 28 deles pediátricos. A média de idade no transplante foi de 3,7 ± 2,2 anos (1 a 12), e o peso médio, de 12,3 ± 2,1 kg (5,6 a 14,9), sendo que 10 tinham peso inferior a 10 kg. Em 10 crianças (16,1%) o transplante foi preemptivo e em 5 (8,1%) havia trombose do sistema venoso prévio ao transplante. Em 1 e 5 anos, a sobrevida do paciente foi de 93,2% e 84,2% e a sobrevida do enxerto de 85,2% e 72,7%, respectivamente, sem diferença entre doadores vivos e falecidos. A função do enxerto com doador vivo foi melhor em 1 e 3 meses, mas a partir do 6o mês foi similar. Houve 6 complicações vasculares, sendo 4 tromboses vasculares, 1 laceração e 1 estenose de artéria renal e 2 coleções líquidas. Houve 17 perdas de enxerto, 6 por morte, sendo 5 com enxerto funcionante, 5 por complicações cirúrgicas, 3 por rejeição crônica e 3 por recorrência da doença de base. Conclusão: O acesso extraperitoneal é uma técnica válida no transplante renal de crianças com peso inferior a 15 kg, assegurando boa sobrevida do paciente e do enxerto e aceitável taxa de complicações, independentemente do tipo de doador, se vivo ou falecido, ou do tamanho do enxerto, se de adulto ou de criança. / Small children are a challenging group for kidney transplantation. This study analyzes the results of kidney transplantation in children weighing less than 15 kg using the extraperitoneal surgical access. Methods: A retrospective review of the records of 62 children weighting less than 15 kg was done. The kidney transplantation were performed between 1998 and 2010 using the extraperitoneal access and anastomosis of the renal vessels of donors to the aorta or common iliac artery and to the inferior vena cava or common iliac vein of the recipients. The ureter was anastomosed to the bladder using the Lich-Grégoir extravesical technique. Results: Thirty-two (51.6%) grafts of the 62 transplants were from living donors and 30 (48.4%) from deceased donors, 28 of them pediatric. The mean age at transplantion was 3.7 ± 2.2 years (1 to 12), and the mean weight, 12.3 ± 2.1 kg (5.6 to 14.9), and 10 of them weighed less than 10 kg. In 10 children (16.1%) the transplant was preemptive. Five 5 (8.1%) children presented previous thrombosis of the venous system. At 1 and 5 years, patient survival was 93.2% and 84.2% and graft survival was 85.2% and 72.7%, respectively, and there was no difference between living and deceased donors. The graft function of the living donor was better at 1 and 3 months, but was similar from the 6th month onward. There were 6 vascular complications (4 of them vascular thromboses, 1 laceration and 1 renal artery stenosis) and 2 perirenal collections. Seventeen grafts were lost, 6 due to death, 5 with a functioning graft, 5 due to surgical complications, 3 due to chronic rejection and 3 due to recurrence of the original disease. Conclusion: The extraperitoneal access is a valid kidney transplantantion technique in children weighing less than 15 kg, ensuring good patient and graft survival, and an acceptable rate of complications, independent of source of donor, living or deceased, or size of graft, whether from an adult or from a child.

Crianças pequenas representam um grupo desafiador no transplante renal. O estudo analisa os resultados, do ponto de vista cirúrgico, do transplante renal em crianças com peso inferior a 15 kg utilizando o acesso cirúrgico extraperitoneal. Métodos: Foram revisados retrospectivamente os prontuários de 62 crianças com peso inferior a 15 kg submetidas a transplante renal entre 1998 e 2010, utilizando o acesso extraperitoneal e anastomose dos vasos renais dos doadores com a aorta ou artéria ilíaca comum e com a veia cava inferior ou ilíaca comum dos receptores. O ureter foi anastomosado à bexiga pela técnica extravesical de Lich- Grégoir. Resultados: Dos 62 transplantes, 32 enxertos (51,6%) eram provenientes de doadores vivos e 30 (48,4%) de doadores falecidos, sendo 28 deles pediátricos. A média de idade no transplante foi de 3,7 ± 2,2 anos (1 a 12), e o peso médio, de 12,3 ± 2,1 kg (5,6 a 14,9), sendo que 10 tinham peso inferior a 10 kg. Em 10 crianças (16,1%) o transplante foi preemptivo e em 5 (8,1%) havia trombose do sistema venoso prévio ao transplante. Em 1 e 5 anos, a sobrevida do paciente foi de 93,2% e 84,2% e a sobrevida do enxerto de 85,2% e 72,7%, respectivamente, sem diferença entre doadores vivos e falecidos. A função do enxerto com doador vivo foi melhor em 1 e 3 meses, mas a partir do 6o mês foi similar. Houve 6 complicações vasculares, sendo 4 tromboses vasculares, 1 laceração e 1 estenose de artéria renal e 2 coleções líquidas. Houve 17 perdas de enxerto, 6 por morte, sendo 5 com enxerto funcionante, 5 por complicações cirúrgicas, 3 por rejeição crônica e 3 por recorrência da doença de base. Conclusão: O acesso extraperitoneal é uma técnica válida no transplante renal de crianças com peso inferior a 15 kg, assegurando boa sobrevida do paciente e do enxerto e aceitável taxa de complicações, independentemente do tipo de doador, se vivo ou falecido, ou do tamanho do enxerto, se de adulto ou de criança. / Small children are a challenging group for kidney transplantation. This study analyzes the results of kidney transplantation in children weighing less than 15 kg using the extraperitoneal surgical access. Methods: A retrospective review of the records of 62 children weighting less than 15 kg was done. The kidney transplantation were performed between 1998 and 2010 using the extraperitoneal access and anastomosis of the renal vessels of donors to the aorta or common iliac artery and to the inferior vena cava or common iliac vein of the recipients. The ureter was anastomosed to the bladder using the Lich-Grégoir extravesical technique. Results: Thirty-two (51.6%) grafts of the 62 transplants were from living donors and 30 (48.4%) from deceased donors, 28 of them pediatric. The mean age at transplantion was 3.7 ± 2.2 years (1 to 12), and the mean weight, 12.3 ± 2.1 kg (5.6 to 14.9), and 10 of them weighed less than 10 kg. In 10 children (16.1%) the transplant was preemptive. Five 5 (8.1%) children presented previous thrombosis of the venous system. At 1 and 5 years, patient survival was 93.2% and 84.2% and graft survival was 85.2% and 72.7%, respectively, and there was no difference between living and deceased donors. The graft function of the living donor was better at 1 and 3 months, but was similar from the 6th month onward. There were 6 vascular complications (4 of them vascular thromboses, 1 laceration and 1 renal artery stenosis) and 2 perirenal collections. Seventeen grafts were lost, 6 due to death, 5 with a functioning graft, 5 due to surgical complications, 3 due to chronic rejection and 3 due to recurrence of the original disease. Conclusion: The extraperitoneal access is a valid kidney transplantantion technique in children weighing less than 15 kg, ensuring good patient and graft survival, and an acceptable rate of complications, independent of source of donor, living or deceased, or size of graft, whether from an adult or from a child.

abstract: Long term high fat diets (HFD) are correlated with the development of diabetes and kidney disease. However, the impact of short term high fat intake on the etiology of kidney disease has not been well-studied. Therefore, this study examined the impact of a six week HFD (60% fat) on kidney structure and function in young male Sprague-Dawley rats. Previous studies have shown that these animals develop indices of diabetes compared to rats fed a standard rodent chow (5% fat) for six weeks. The hypothesis of this study is that six weeks of HFD will lead to early stages of kidney disease as evidenced by morphological and functional changes in the kidney. Alterations in morphology were determined by measuring structural changes in the kidneys (changes in mass, fatty acid infiltration, and structural damage). Alterations in kidney function were measured by analyzing urinary biomarkers of oxidative RNA/DNA damage, renal tissue lipid peroxidation, urinary markers of impaired kidney function (urinary protein, creatinine, and hydrogen peroxide (H2O2)), markers of inflammation (tumor necrosis factor alpha (TNFα) and interleukin 6 (IL-6)), as well as cystatin C, a plasma biomarker of kidney function. The results of these studies determined that short term HFD intake is not sufficient to induce early stage kidney disease. Beyond increases in renal mass, there were no significant differences between the markers of renal structure and function in the HFD and standard rodent chow-fed rats. / Dissertation/Thesis / Masters Thesis Nutrition 2015

A ingestão excessiva de fluoreto por um longo período de tempo pode resultar em fluorose, que pode causar manifestações dentárias e esqueléticas. Danos metabólicos, funcionais e estruturais causados pela fluorose crônica tem sido relatados em vários tecidos. O objetivo deste estudo foi avaliar os efeitos do fluoreto administrado na água de beber, da administração de fluoreto na água de beber na defesa antioxidante de ratos. Quatro grupos de ratos wistar foram usados (n=10/grupo). Os animais receberam água de beber contendo 0 (controle), 5, 15 ou 50 ppm de fluoreto durante 60 dias. Eles foram eutanasiados e os tecidos (fígado, rins e coração) e plasma foram coletados e homogenizados. Superóxido dismutase (SOD), catalase (CAT), glutationa peroxidase (GPx), glutationa reduzida (GSH), substâncias antioxidantes totais (SAT), substâncias reativas ao ácido tiobarbitúrico (TBARS), hidroperóxido de lipídios (HL) e fluoreto foram análisadas. Dados foram analisados por ANOVA e teste de Tukey ou Kruskal-Wallis e teste de Dunn (p<0,05). Nos rins, SOD, GPx, GSH e SAT diminuiram e fluoreto e HL aumentaram significantivamente. No fígado, CAT e TBARS diminuiram, SOD, HL e SAT aumentaram significativamente. No coração, GPx aumentou significativamente. No plasma, SOD e HL diminuiram significativamente. Em resumo, esses resultados mostram que a administração crônica de fluoreto altera o sistema antioxidante de ratos. Nosso dados sugerem que a exposição em níveis elevados de fluoreto, a conversão do ânion superóxido em água nos rins parecem ocorrer principalmente através da SOD e CAT, com baixa participação do sistema glutationa, diferindo do que parece ocorrer no fígado. / Excessive fluoride intake over a long period of time could result in fluorosis, which can lead to dental and skeletal manifestations. Metabolic, functional and structural damages caused by chronic fluorosis have been reported in many tissues. The aim of this study was to evaluate the effect of fluoride, administered in drinking water, in the antioxidant defense of rats. Four groups of Wistar rats were included (n=10/group). The animals received drinking water containing 0 (control), 5, 15 or 50 ppm of fluoride during 60 days. They were euthanized and the tissues (liver, kidney and heart) and plasma were collected and homogenized. Superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH), antioxidants, thiobarbituric acid reactive substances (TBARS), lipid hydroperoxide (LH), and fluoride were analyzed. Data were analyzed by ANOVA and Tukeys test or Kruskal-Wallis and Dunns tests (p<0.05). In the kidney SOD, GPx, GSH and SAT decreased and fluoride and LH increased significantly. In the liver, CAT and TBARS decreased and fluoride, SOD, LH and SAT increased significantly. In the heart, GPx increased significantly. In the plasma, SOD and LH decreased significantly. In summary, these results show that chronic fluoride administration alters the antioxidant system of the rats. Our data suggest that upon exposure to high levels of fluoride, the conversion of the superoxide anion to water in the kidney seems to occur mainly through the SOD and CAT, with a low participation of the glutathione system, differing from what seems to occur in the liver.

Crianças pequenas representam um grupo desafiador no transplante renal. O estudo analisa os resultados, do ponto de vista cirúrgico, do transplante renal em crianças com peso inferior a 15 kg utilizando o acesso cirúrgico extraperitoneal. Métodos: Foram revisados retrospectivamente os prontuários de 62 crianças com peso inferior a 15 kg submetidas a transplante renal entre 1998 e 2010, utilizando o acesso extraperitoneal e anastomose dos vasos renais dos doadores com a aorta ou artéria ilíaca comum e com a veia cava inferior ou ilíaca comum dos receptores. O ureter foi anastomosado à bexiga pela técnica extravesical de Lich- Grégoir. Resultados: Dos 62 transplantes, 32 enxertos (51,6%) eram provenientes de doadores vivos e 30 (48,4%) de doadores falecidos, sendo 28 deles pediátricos. A média de idade no transplante foi de 3,7 ± 2,2 anos (1 a 12), e o peso médio, de 12,3 ± 2,1 kg (5,6 a 14,9), sendo que 10 tinham peso inferior a 10 kg. Em 10 crianças (16,1%) o transplante foi preemptivo e em 5 (8,1%) havia trombose do sistema venoso prévio ao transplante. Em 1 e 5 anos, a sobrevida do paciente foi de 93,2% e 84,2% e a sobrevida do enxerto de 85,2% e 72,7%, respectivamente, sem diferença entre doadores vivos e falecidos. A função do enxerto com doador vivo foi melhor em 1 e 3 meses, mas a partir do 6o mês foi similar. Houve 6 complicações vasculares, sendo 4 tromboses vasculares, 1 laceração e 1 estenose de artéria renal e 2 coleções líquidas. Houve 17 perdas de enxerto, 6 por morte, sendo 5 com enxerto funcionante, 5 por complicações cirúrgicas, 3 por rejeição crônica e 3 por recorrência da doença de base. Conclusão: O acesso extraperitoneal é uma técnica válida no transplante renal de crianças com peso inferior a 15 kg, assegurando boa sobrevida do paciente e do enxerto e aceitável taxa de complicações, independentemente do tipo de doador, se vivo ou falecido, ou do tamanho do enxerto, se de adulto ou de criança. / Small children are a challenging group for kidney transplantation. This study analyzes the results of kidney transplantation in children weighing less than 15 kg using the extraperitoneal surgical access. Methods: A retrospective review of the records of 62 children weighting less than 15 kg was done. The kidney transplantation were performed between 1998 and 2010 using the extraperitoneal access and anastomosis of the renal vessels of donors to the aorta or common iliac artery and to the inferior vena cava or common iliac vein of the recipients. The ureter was anastomosed to the bladder using the Lich-Grégoir extravesical technique. Results: Thirty-two (51.6%) grafts of the 62 transplants were from living donors and 30 (48.4%) from deceased donors, 28 of them pediatric. The mean age at transplantion was 3.7 ± 2.2 years (1 to 12), and the mean weight, 12.3 ± 2.1 kg (5.6 to 14.9), and 10 of them weighed less than 10 kg. In 10 children (16.1%) the transplant was preemptive. Five 5 (8.1%) children presented previous thrombosis of the venous system. At 1 and 5 years, patient survival was 93.2% and 84.2% and graft survival was 85.2% and 72.7%, respectively, and there was no difference between living and deceased donors. The graft function of the living donor was better at 1 and 3 months, but was similar from the 6th month onward. There were 6 vascular complications (4 of them vascular thromboses, 1 laceration and 1 renal artery stenosis) and 2 perirenal collections. Seventeen grafts were lost, 6 due to death, 5 with a functioning graft, 5 due to surgical complications, 3 due to chronic rejection and 3 due to recurrence of the original disease. Conclusion: The extraperitoneal access is a valid kidney transplantantion technique in children weighing less than 15 kg, ensuring good patient and graft survival, and an acceptable rate of complications, independent of source of donor, living or deceased, or size of graft, whether from an adult or from a child.

Doença renal crônica é uma afecção comum em cães e gatos, especialmente em gatos senis, e importante causa de morbidade e mortalidade. Além da idade avançada, fatores como alterações congênitas, alimentação inadequada, utilização de drogas nefrotóxicas, intoxicações e doenças infecciosas predispõem às lesões do parênquima renal. Em felinos a descrição histopatológica mais frequente é a nefrite tubulointersticial difusa. Independente da causa do dano ao néfron, a doença renal crônica é uma afecção irreversível e geralmente progressiva. Este estudo teve por objetivo realizar uma análise da contribuição da ultrassonografia utilizando-se o modo B e Doppler colorido e pulsado para o diagnóstico e estagiamento da doença renal crônica em 45 felinos. Sendo 16 do grupo controle, felinos que não portavam manifestações clínicas relacionadas ao sistema urinário, apresentavam concentração sérica de creatinina inferior a 1,6mg/dL; quatro do estágio 1, felinos com taxas de creatinina sérica inferior a 1,6mg/dL com alterações ultrassonográficas; 17 do estágio II, felinos com taxas de creatinina 1,6 a 2,8mg/dL; oito do estágio III / IV, felinos com taxa de creatinina sérica de 2,9 a 5,0mg/dL agrupados aos felinos com taxa de creatinina sérica acima de 5,0mg/dL. Os rins foram avaliados ultrassonograficamente por meio das características: ecogenicidade da cortical, regularidade de contorno e definição corticomedular no modo B; comprimento, largura e altura nos cortes longitudinal, transversal e dorsal no modo B; preenchimento das artérias interlobares, arqueadas e interlobulares por meio do Doppler colorido; e índice de resistividade dos vasos intrarenais por meio do Doppler pulsado. Foi determinada a relação comprimento do rim pelo diâmetro luminal da aorta nos felinos normais e nefropatas. Conclui-se que o aumento da ecogenicidade da cortical demonstrou-se uma característica relevante a ser considerada na avaliação ultrassonográfica da doença renal crônica. O Doppler colorido mostrou-se uma ferramenta importante no diagnóstico da doença renal crônica, especialmente quando as alterações detectadas à avaliação ultrassonográfica pelo modo B não eram expressivas. O índice de resistividade não se apresentou acima do limite da normalidade nos estágios iniciais da doença renal crônica, sugerindo não ser útil como preditor da nefropatia crônica. As alterações na avaliação ultrassonográfica modo B associadas ao aumento do índice de resistividade podem indicar um pior prognóstico da evolução da doença renal crônica. Achados ultrassonográficos como ecogenicidade da cortical aumentada, irregularidade de contorno, indefinição corticomedular, diminuição do preenchimento vascular pelo Doppler colorido e aumento do índice de resistividade são elementos importantes a serem considerados no estabelecimento do diagnostico da doença renal crônica em felinos. / Chronic kidney disease is common in dogs and cats, especially in older cats, and an important cause of morbidity and mortality. Factors like advanced age, congenital alterations, inappropriate nutrition, use of nephrotoxic drugs, intoxications and infectious disease may lead to parenchymal lesions in kidney. The most frequent histopathologic change in cats is diffuse tubulointertitial nephritis. Independent of the cause of the nephron damage, the chronic renal disease is an irreversible and usually progressive affection. This study aim to analyze the contribution of ultrasography in the diagnosis and staging of chronic kidney diseases using B mode, color Doppler and spectral Doppler. Sixteen presenting no manifestation of urinary disease and serum creatinine levels less than 1,6mg/dL served at control group; four cats represented stage I, with serum creatinine levels less than 1,6mg/dL and ultrasonographic changes; 17 cats represented stage II, with serum creatinine levels between 1,6 and 2,8mg/dL; eight cats represented stage III/IV, with serum creatinine levels between 2,9 e 5,0mg/dL, grouped with the felines with serum creatinine levels above 5,0mg/dL. The kidneys underwent an ultrasonographic examination observing: cortical echogenicity, regularity of the contour and corticomedullary definition in the B mode; length, width and height in the longitudinal, transverse and dorsal planes in the B mode; filling of the interlobars, arcuate and interlobulars arteries by the color Doppler; and resistive index of the intrarenal vessels using the pulsed Doppler. The ratio between the length of the kidney and the luminal diameter of the aorta in normal felines and in felines with kidney disease was established. The increase in echogenicity of the cortex showed to be a relevant characteristic to be considered in the ultrasonographic evaluation of chronic kidney disease. The color Doppler showed to be an important tool in the diagnosis of the chronic kidney disease, especially when the alterations in the B mode werent expressive. The resistive index did not present itself above of the normal limits in the initial stages of the chronic kidney disease, suggesting its uselessness as a predictor of the chronic kidney disease. Changes in B mode associated with increase in resistive index may indicate a poor prognostics of the chronic kidney disease. Increase in the echogenicity of the cortical, contour irregularity, corticomedullary indefinition, reduced vascular filling detected by color Doppler and the increase in the resistive index were important elements to be considered in the diagnosis of the chronic kidney disease.

Background: We evaluated the concept of whether liver failure patients with a superimposed kidney injury receiving a simultaneous liver and kidney transplant (SLKT) have similar outcomes compared to patients with liver failure without a kidney injury receiving a liver transplantation (LT) alone. Methods: Using data from the United Network of Organ Sharing (UNOS) database, patients were divided into five groups based on pre-transplant model for end-stage liver disease (MELD) scores and categorized as not having (serum creatinine (sCr) <= 1.5 mg/dL) or having (sCr > 1.5 mg/dL) renal dysfunction. Of 30,958 patients undergoing LT, 14,679 (47.5%) had renal dysfunction, and of those, 5,084 (16.4%) had dialysis. Results: Survival in those (liver failure with renal dysfunction) receiving SLKT was significantly worse (P < 0.001) as compared to those with sCr < 1.5 mg/dL (liver failure only). The highest mortality rate observed was 21% in the 36+ MELD group with renal dysfunction with or without SLKT. In high MELD recipients (MELD > 30) with renal dysfunction, presence of renal dysfunction affects the outcome and SLKT does not improve survival. In low MELD recipients (16 - 20), presence of renal dysfunction at the time of transplantation does affect post-transplant survival, but survival is improved with SLKT. Conclusions: SLKT improved 1-year survival only in low MELD (16 - 20) recipients but not in other groups. Performance of SLKT should be limited to patients where a benefit in survival and post-transplant outcomes can be demonstrated.

Ischemia and reperfusion are natural steps during kidney transplantation, and IRI is considered one of the most important nonspecific factors affecting allograft dysfunction. Transplanted organs experience several episodes of ischemia, in which cold ischemia occurs during allograft storage in preservation solutions. Even though cold ischemia has been studied extensively, all of the studies have been carried out in vitro and ex vivo models. There is no in vivo model available to examine renal IRI induced solely by cold ischemia. In the present study, we developed an in vivo mouse model to study renal IRI induced exclusively by cold ischemia through clamping the renal pedicle for 1 to 5 hours. During the ischemic phase, blood was flushed from the kidney with cold saline through a small opening on the renal vein. The kidney was kept cold in a kidney cup with circulating cooled saline, while the body temperature was maintained at 37℃ during the experiment. The level of kidney injury was evaluated by plasma creatinine, KIM-1, NAGL, GFR, and histology. Plasma creatinine was significantly increased from 0.15±0.04 mg/dl in the sham group to 1.14±0.21 and 2.65±0.14 mg/dl in 4 and 5-hours ischemia groups at 24 hours after cold IRI. The plasma creatinine in mice with ischemic time <3 hours demonstrated no significant increase compared with sham mice. Changes in KIM-1, NAGL, GFR and histology were similar to plasma creatinine. 65 In summary, we developed and characterized a novel in vivo IRI-induced AKI mouse model exclusively produced by cold ischemia.

There is an epidemic of chronic kidney disease of unknown origin (CKDu) primarily affecting younger men in Central America, especially El Salvador and Nicaragua. The primary hypothesis has included heat stress and dehydration. Although medication usage is widely viewed as a likely contributor to kidney damage, the association with chronic kidney disease in Central America has not been fully explored. This study investigated medication usage, symptom presentation, and kidney function among 524 outdoor workers in agricultural and non-agricultural industries enrolled in the Mesoamerican Nephropathy Occupational Study (MANOS) led by Boston University researchers. An overview of the literature on the adverse effects of medication on renal function and thermoregulation, with a focus on medications considered in MANOS, was conducted. Medication usage and symptom presentation on both a short- and long-term timeframe were explored in relation to kidney function measured by estimated glomerular filtration rate. Long-term usage of NSAIDS and potassium supplements was significantly associated with kidney function. Neither short- or long-term uses of acetaminophen, the most commonly used medication, were associated with kidney function. While several self-reported health symptoms were significantly associated with lower kidney function in crude models, the associations’ significance levels lessened after adjusting for age, country, and industry. In contrast, symptoms of chistata (a local term for painful urination) and lower abdominal pain three months prior to data collection each significantly predicted higher kidney function. The results of this exploratory, cross-sectional study present an opportunity for further study on how medications and symptoms, related to both nephrotoxicity and heat stress, could be associated with kidney function.