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Master Thesis

La néphrite tubulo-interstitielle chronique dans les communautés agricoles dite « CINAC » à La Réunion

Abstract : Background: chronic Intersitial Nephritis in Agricultural Communities (CINAC) is a nephropathy among agricultural users of pesticides. Its evolution to End-Stage Renal Disease (ESRD) is fast and the proteinuria is low or absent. ESRD prevalence is 3.7 times higher on Reunion Island compared to Metropolitan France. Pesticide exposures are multiple on Reunion: through agriculture, water and aliments intake, domestic use and vector control. Objective: to search for CINAC compatible nephropathies among farmers on dialysis. To search secondarily for a relation between farm-work, pesticide exposure and the evolution of chronic kidney disease (CKD). Material and Methods : patients under dialysis from 20 to 90 who worked as farmer at least during a year, who used pesticides and who had a not determined nephropathy were questioned and data on their nephropathy were collected. Results: 31 out of 983 patients included in the screening were suspect for a CINAC. 44.4% of them had already a stage 4 or 5 CKD when they first encountered a nephrologist. Patients used very few personal protective equipments and their personal exposure to pesticides varied a lot. The most used pesticides were paraquat, glyphosate, 2,4-D and deltamethrin. CKD evolution was faster among patients who worked for a shorter duration. There was no relation between CKD evolution and pesticide exposure. Conclusion: CINAC is potentially present on Reunion Island but further histological analysis and prospective investigations among patients with possible CINAC disease and CKD 2 and 3A from nephrology consultation are needed.
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Submitted on : Monday, January 25, 2021 - 3:53:35 PM
Last modification on : Wednesday, February 3, 2021 - 3:11:14 AM
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  • HAL Id : dumas-03120557, version 1



Juliette Belanger. La néphrite tubulo-interstitielle chronique dans les communautés agricoles dite « CINAC » à La Réunion. Sciences du Vivant [q-bio]. 2020. ⟨dumas-03120557⟩



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