Tatalaksana Komprehensif Gangguan Ginjal pada Pekerja Industri Gula

Main Article Content

Badrul Munir
Meddy Setiawan
Febri Endra Budi Setyawan
Feny Tunjungsari


Sugarcane workers have a higher risk of being exposed to pesticides where pesticides have high toxicity. One of the most common diseases is kidney disorders, including acute kidney injury and chronic kidney disease of unknown disease or known as mesoamerican nephropathy. This study is a literature review to determine the comprehensive management of kidney disorders in sugar industry workers. A comprehensive review was conducted by searching for national and international journals in the last 6 years which were identified according to the topic. Kidney disease in sugarcane workers can take the form of acute kidney injury in the acute phase and become chronic if the risk factors cannot be overcome. Risk factors for kidney disease in sugarcane workers are dehydration, pesticides, heat stress, strenuous physical activity, exposure to sugarcane burning smoke. Preventive steps that can be taken include providing good fluid intake, providing good rest areas, setting working hours, modifying special backpacks for water bottles, procuring appropriate personal protective equipment and using bagasse to reduce cadmium ions in pesticides. If kidney disease has occurred, monitoring and treatment is carried out according to the level of the disease so that it does not get worse. Sugar industry workers have various risks for the occurrence of kidney disease. Management that includes promotive, preventive, curative and rehabilitative can be done to provide comprehensive services for kidney disorders in sugarcane workers.


Download data is not yet available.

Article Details

How to Cite
Munir, B., Setiawan, M., Setyawan, F. E. B., & Tunjungsari, F. (2022). Tatalaksana Komprehensif Gangguan Ginjal pada Pekerja Industri Gula. CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal, 3(2), 94-109. https://doi.org/10.37148/comphijournal.v3i2.108


Kellum JA, Lameire N, Aspelin P, Barsoum RS, Burdmann EA, Goldstein SL, et al. Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO Clinical Practice Guideline for Acute Kidney Injury. Kidney International Supplements. 2012 Mar;2(1):1-138. DOI: 10.1038/kisup.2012.1. Available From: https://www.scopus.com/record/display.uri?eid=2-s2.0-84884342549&origin=inward&txGid=b731496ab6ebd25461bfaab3ea18e677.

Luyckx VA, Tonelli M, Stanifer JW. World Health Organization. The Global Burden of Kidney Disease and The Sustainable Development Goals. Bulletin of The World Health Organization. 2018;96:414–422C. DOI: http://dx.doi.org/10.2471/BLT.17.206441. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5996218/pdf/BLT.17.206441.pdf.

Major Safety and Health Hazards The Scale of the Child Labour Problem. International Labour Organization. 2001.

Fatima SA, Shahid I. Study of Occupational Health and Safety Conditions of a Sugar Mill in Pakistan. Journal of Biodiversity and Environmental Sciences (JBES). 2017 July 21;11(1):97–104. Available From: https://dokumen.tips/download/link/study-of-occupational-health-and-safety-conditions-of-a-of-occupational-health.

Nerbass FB, Filho RP, Clark WF, Sontrop JM, McIntyre CW, Moist L. Occupational Heat Stress and Kidney Health: From Farms to Factories. Kidney Int Reports. 2017 August 29;2:998–1008. DOI: 10.1016/j.ekir.2017.08.012. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5733743/.

Dawson JB, Krisher L, Asensio C, Cruz A, Tenney L, Weitzenkamp D, et al. Risk Factors for Declines in Kidney Function in Sugarcane Workers in Guatemala. J Occup Environ Med. 2018;60(6):548–558. DOI:10.1097/JOM.0000000000001284. Available From: https://pubmed.ncbi.nlm.nih.gov/29370016/.

World Health Organization Regional Office for the Eastern Mediterranean. Occupational Health a Manual for Primary Health Care Workers. World Health Organization. 2001. Available From: https://www.who.int/occupational_health/regions/en/oehemhealthcareworkers.pdf?ua=1.

Setyawan FEB. Holistik Komprehensif. In: Pendekatan Pelayanan Kesehatan Dokter Keluarga (Pendekatan Holistik Komprehensif). Malang: Zifatama Jawara, 2019. 180 p.

Kefale B. Current Management of Chronic Kidney Disease: Literature Review. JOJ Urology & Nephrology. 2018 December;6(2):0032-0039. DOI: 10.19080/JOJUN.2018.06.555684. Available From: https://juniperpublishers.com/jojun/pdf/JOJUN.MS.ID.555684.pdf.

Oluseyi A, Ayodeji A, and Fasaanu A. Aetiologies and Short-term Outcomes of Acute Kidney Injury in a Tertiary Centre in Southwest Nigeria. Ethiopian Journal of Health Sciences. 2016 January;26(1):37-44. DOI: http://dx.doi.org/10.4314/ejhs.v26i1.8. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4762958/pdf/EJHS2601-0037.pdf.

Delima D, Tjitra E, Tana L, Halim FS, Ghani L, Siswoyo H, et al. Faktor Risiko Penyakit Ginjal Kronik: Studi Kontrol di Empat Rumah Sakit di Jakarta Tahun 2014. Buletin Penelitian Kesehatan. 2017;45(1):17–26. http://dx.doi.org/10.22435/bpk.v45i1.5771.17-26. Available From: https://www.neliti.com/publications/74905/faktor-risiko-penyakit-ginjal-kronik-studi-kasus-kontrol-di-empat-rumah-sakit-di.

Valckle M, Levasseur ME, Silva ASd, Wesseling C. Pesticide Exposures and Chronic Kidney Disease of Unknown Etiology: an Epidemiologic Review. Environmental Health. 2017 May 23;16(49):1–20. DOI 10.1186/s12940-017-0254-0. Available From: https://ehjournal.biomedcentral.com/articles/10.1186/s12940-017-0254-0.

Ordunez P, Nieto FJ, Martinez R, Soliz P, Giraldo GP, Mott SA, Hoy WE. Chronic Kidney Disease Mortality Trends in Selected Central America Countries , 1997–2013: Clues to an Epidemic of Chronic Interstitial Nephritis of Agricultural Communities. Journal of Epidemiology and Community Health. 2018 February;72(4):280-286. DOI: 10.1136/jech-2017-210023. Available From: http://publichealthintelligence.org/content/chronic-kidney-disease-mortality-trends-selected-central-america-countries-1997–2013-clues.

Ekiti ME, Zambo JB, Assah FK, Agbor VN, Kekay K, and Ashuntantang G. Chronic Kidney Disease in Sugarcane Workers in Cameroon: a Cross-Sectional Study. BMC Nephrology. 2018;19(10):1-8. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5769452/.

Santos UP, Zanetta DMT, Filho MT, Burdmann EA. Burnt Sugarcane Harvesting is Associated with Acute Renal Dysfunction. Kidney International. 2015 April;87(4):792–799. DOI: 10.1038/ki.2014.306. Available From: https://pubmed.ncbi.nlm.nih.gov/25229334/.

Hansson E, Glaser J, Jakobsson K, Weiss I, Wesseling C, Rebekah AIL, et al. Pathophysiological Mechanisms by Which Heat Stress Potentially Induces Kidney Inflammation and Chronic Kidney Disease in Sugarcane Workers. Multidisciplinary Digital Publishing Institute: Nutrients. 2020 June 2;12(6):1-22. https://doi.org/10.3390/nu12061639. Available From: https://www.mdpi.com/2072-6643/12/6/1639.

Wagoner RS, Gálvez NIL, Zapien JGd, Griffin SC, Canales RA, Beamer PI. An Occupational Heat Stress and Hydration Assessment of Agricultural Workers in North Mexico. Kidney International. 2020 March 22; Vol. 17(6): 1-13. DOI:10.3390/ijerph17062102. Available From: https://www.mdpi.com/1660-4601/17/6/2102.

Glaser J, Hansson E, Weiss I, Wesseling C, Jakobsson K, Ekström U, et al. Preventing Kidney Injury Among Sugarcane Workers: Promising Evidence from Enhanced Workplace Interventions. Occupational Environmental Medicine. 2020;0:1–8. DOI: 10.1136/oemed-2020-106406. Available From: https://oem.bmj.com/content/early/2020/05/12/oemed-2020-106406.

Dawson JB, Krisher L, Yoder H, Dally M, Sorensen, C, Johnson RJ, et al. Evaluation of Heat Stress and Cumulative Incidence of Acute Kidney Injury in Sugarcane Workers in Guatemala. International Archives of Occupational and Environmental Health. 2019 April 17;92:977-990. DOI: 10.1007/s00420-019-01426-3. Available From: https://link.springer.com/content/pdf/10.1007/s00420-019-01426-3.pdf.

Johnson RJ, Wesseling C, Newman LS. 2019 Chronic Kidney Disease of Unknown Cause in Agricultural Communities. The New England Journal of Medicine. 2019 May 9;380(19): 1843-1852. Available From: https://www.nejm.org/doi/full/10.1056/NEJMra1813869.

Scammell MK, Sennett CM, Petropoulos ZE, Jeanne K and Kaufman JS. Environmental and Occupational Exposures in Kidney Disease. Seminars in Nephrology. May 2019 1;39(3):230−243. https://doi.org/10.1016/j.semnephrol.2019.02.001. Available From: https://www.seminarsinnephrology.org/article/S0270-9295(19)30007-5/fulltext.

Islamuddin, Gautam RK, and More N. Modified Sacchurum Officinarum (Sugarcane Bagasse [Sb]) Activated Powder Used as a Natural Adsorbent for the Removal of Cadmium (Cd) From Simulated Wastewater (Aqueous Solution). International Journal for Research in Applied Science & Engineering Technology (IJRASET). 2017 January;5(1):212-218. Available From: https://www.researchgate.net/publication/335228104_Modified_Sacchurum_Officinarum_Sugarcane_Bagasse_Sb_Activated_Powder_Used_as_a_Natural_Adsorbent_for_the_Removal_of_Cadmium_Cd_From_Simulated_Wastewater_Aqueous_Solution/link/5d59176a92851cb74c74d2d6/download.

Jimenez CR, Lanaspa MA, Jensen T, Lozada LGS, Johnson RJ. Mechanisms by Which Dehydration May Lead to Chronic Kidney Disease. Annals of Nutrition & Metabolism. 2015;66(suppl 3):10–13. DOI: 10.1159/000381239. Available From: https://www.karger.com/Article/FullText/381239.

Dally M, Dawson JB, Krisher L, Monaghan A, Weitzenkamp D, Sorensen C, et al. The Impact of Heat and Impaired Kidney Function on Productivity of Guatemalan Sugarcane Workers. PLoS ONE. 2018 October 5; 13(10): DOI: 10.1371/journal.pone.0205181.http://www.ncbi.nlm.nih.gov/pubmed/30289894. Available From: https://pubmed.ncbi.nlm.nih.gov/30289894/.

Bouwarthan MA, Quinn MM, Kriebel D, and Wegman DH. Risk of Kidney Injury Among Construction Workers Exposed to Heat Stress: A Longitudinal Study from Saudi Arabia. Int. J. Environ. Res. Public Health. 2020 May 26; 17(11):1-16. https://doi.org/10.3390/ijerph17113775. Available From: https://pubmed.ncbi.nlm.nih.gov/32466510/.

Nerbass FB, Moist L, Clark WF, Vieira MA, and Filho RP. Hydration Status and Kidney Health of Factory Workers Exposed to Heat Stress: A Pilot Feasibility Study. Annaals of Nutrion & Metabolism. 2019 June 14;74(suppl 3):30-37. DOI: 10.1159/000500373. Available From: https://www.karger.com/Article/FullText/500373.

Crowe J, Nilsson M, Kjellstrom T, and Wesseling C. Heat-Related Symptoms in Sugarcane Harvesters. American Journal Of Industrial Medicine. 2015 April 7;58(5):541–548. https://doi.org/10.1002/ajim.22450. Available From: https://docksci.com/queue/heat-related-symptoms-in-sugarcane-harvesters_5a55233dd64ab2a14aa71d22.html.

Dawson JB, Dally M, Johnson RJ, Johnson EC, Krisher L, Lozada LGS, Griffin BR, et al. Association of Copeptin, a Surrogate Marker of Arginine Vasopressin, with Decreased Kidney Function in Sugarcane Workers in Guatemala. Annals of Nutrition & Metabolism. 2020 March 13;76(1):30-36. DOI: 10.1159/000506619. Available From: https://pubmed.ncbi.nlm.nih.gov/32172243/.

Sorensen CJ, Dawson JB, Dally M, Krisher L, Griffin BR, Johnson RJ, et al. Risk Factors and Mechanisms Underlying Crossshift Decline in Kidney Function in Guatemalan Sugarcane Workers. J Occup Environ Med. 2019 March;61(3):239–250. DOI: 10.1097/JOM.0000000000001529. Available From: https://pubmed.ncbi.nlm.nih.gov/30575695/.

Trabanino RG, Jarquin E, Wesseling C, Johnson RJ, Quiroz MJ, Weiss I, et al. Heat Stress, Dehydration, and Kidney Function in Sugarcane Cutters in EI Salvador—a Cross-Shift Study of Workers at Risk of Mesoamerican Nephropathy. Environ Res. 2015;142:746–755. DOI: 10.1016/j.envres.2015.07.007. Available From: https://pubmed.ncbi.nlm.nih.gov/26209462/.

Hansson E, Glaser J, Weiss I, Ekström U, Apelqvist J, Hogstedt C, et al. Workload and Cross-Harvest Kidney Injury in a Nicaraguan Sugarcane Worker Cohort. Occupational and Environmental Medicine. 2019;76:818-826. DOI: 10.1136/oemed-2019-105986. Available From: http://oem.bmj.com/lookup/doi/10.1136/oemed-2019-105986.

Seneff S and Orlando LF. Is Glyphosate a Key Factor in Mesoamerican Nephropathy?. Journal of Environmental & Analytical Toxicology. 2018;8(1):1-10. DOI: 10.4172/2161-0525.1000542. Available From: https://www.hilarispublisher.com/open-access/is-glyphosate-a-key-factor-in-mesoamerican-nephropathy-2161-0525-1000542.pdf.

Ariyanto A, Hadisaputro S, Lestariningsih L, and Adi MS. Beberapa Faktor Risiko Kejadian Penyakit Ginjal Kronik (PGK) Stadium V pada Kelompok Usia Kurang dari 50 Tahun (Studi di RSUD dr. H.Soewondo Kendal dan RSUD dr. Adhyatma,MPH Semarang). Jurnal Epidemiologi Kesehatan Komunitas. 2018 February 20;3(1):1-6. https://doi.org/10.14710/jekk.v3i1.3099. Available From: https://ejournal2.undip.ac.id/index.php/jekk/article/view/3099.

Valdés RH, Orantes CM, López MA, Marín LL, Arévalo PA, González MJS, et al. Clinical Characteristics of Chronic Kidney Disease of Non-Traditional Causes in Women of Agricultural Communities in El Salvador. Clinical Nephrology. 2015;83(7 Suppl 1):56-63. DOI: 10.5414/cnp83s056. Available From: https://pubmed.ncbi.nlm.nih.gov/25725244/.

Laws RL, Brooks DR, Amador JJ, Weiner DE, Kaufman JS, Rubio OR, et al. Biomarkers of Kidney Injury Among Nicaraguan Sugarcane Workers. Am J Kidney Dis. 2016 February;67(2):209–217. https://doi.org/10.1053/j.ajkd.2015.08.022. Available From: https://pubmed.ncbi.nlm.nih.gov/26454687/.

Raúl H, Orantes CM, Almaguer M, Alfonso P, Bayarre HD, Leiva IM, et al. Clinical Characteristics of Chronic Kidney Disease of Nontraditional Causes in Salvadoran Farming Communities. MEDICC Review. 2014 April;16(2):39-48. Available From: https://pubmed.ncbi.nlm.nih.gov/24878648/.

Flatharta TÓ, Flynn A, Mulkerrin EC. Heat-Related Chronic Kidney Disease Mortality in The Young And Old: Differing Mechanisms, Potentially Similar Solutions?. BMJ Evidence-Based Medicine. 2019 April;24(2):45–47. DOI: 10.1136/bmjebm-2018-110971. Available From: https://ebm.bmj.com/content/early/2018/09/27/bmjebm-2018-110971?versioned=true.

Kupferman J, Rubio OR, Amador JJ, Pilarte DL, Wilker EH, Laws RL, et al. Acute Kidney Injury in Sugarcane Workers at Risk for Mesoamerican Nephropathy. Am J Kidney Dis (AJKD). 2018 October;XX(XX):1-8. DOI: 10.1053/j.ajkd.2018.04.014. Available From: https://pubmed.ncbi.nlm.nih.gov/30042041/.

Bodin T, Trabanino RG, Weiss I, Jarquín E, Glaser J, Jakobsson K, Lucas RAI, et al. Intervention to Reduce Heat Stress and Improve Efficiency Among Sugarcane Workers in El Salvador: Phase 1. Occupational and Environmental Medicine (Occup Environ Med). 2016 April 12;73:409-416. DOI:10.1136/oemed-2016-103555. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4893112/.

Elinder CG, Wernerson A, and Wijkström J. Mesoamerican Nephropathy (MeN): A ‘New’ Chronic Kidney Disease Related to Occupational Heat Exposure with Repeated Deprivation of Salts and Water. International Journal of Nephrology and Kidney Failure. 2015 August 25;1(2): 1-9. DOI: http://dx.doi.org/10.16966/2380-5498.109. Available From: https://www.sciforschenonline.org/journals/nephrology-kidney/IJNKF-1-109.php.

Glaser J, Hansson E, Weiss I, Wesseling C, Jakobsson K, Ekström U, et al. Preventing Kidney Injury Among Sugarcane Workers: Promising Evidence From Enhanced Workplace Interventions. Occupational and Environmental Medicine. 2020 May 13;0:1–8. DOI:10.1136/oemed-2020-106406. Available From: https://oem.bmj.com/content/early/2020/05/12/oemed-2020-106406.

Hailu T. Assessment of The Prevalence of Heat Stress Related Illness Among Outdoor Sugar Factories Workers in Ethiopia. Addis Ababa University, College Of Health Science, School Of Public Health, Department Of Preventive Medicine Environmental And Occupational Health Unit. 2018 June. Available From: http://etd.aau.edu.et/bitstream/handle/123456789/14823/Teklu%20Hailu.pdf?sequence=1&isAllowed=y.

Wegman DH, Apelqvist J, Bottai M, Ekström U, Trabanino RG, Glaser J, et al. Intervention to Diminish Dehydration and Kidney Damage Among Sugarcane Workers. Scand J Work Environ Health.2018 January 1;44(1):16-24. DOI: 10.5271/sjweh.3659.Epub. Available From: https://pubmed.ncbi.nlm.nih.gov/28691728/.

Hertzberg D, Ryden L, Pickering JW, Sartipy U, and Holzmann MJ. Acute Kidney Injury—an Overview of Diagnostic Methods and Clinical Management. Clinical Kidney Journal. 2017;10(3):323–331. DOI: 10.1093/ckj/sfx003. Available From: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5466115/.

Ito O. Renal Rehabilitation in Patients with Chronic Kidney Disease. Physical Medicine and Rehabilitation Research. 2017 August 31;2(5):1-4. DOI: 10.15761/ PMRR.1000S1002. Available From: https://www.oatext.com/pdf/PMRR-S1-002.pdf.

Silver SA, Adu D, Agarwal S, Gupta KL, Lewington AJP, Pannu N, et al. Strategies to Enhance Rehabilitation After Acute Kidney Injury in the Developing World. Kidney International Reports. 2017 July;2(4):579–593. https://doi.org/10.1016/j.ekir.2017.04.005. Available From: https://www.sciencedirect.com/science/article/pii/S2468024917301006.

Most read articles by the same author(s)

1 2 > >>