Risk of kidney health among returnee Nepali

Summary: Risk of kidney health among returnee Nepali migrant workers: A survey of nephrologists (completed)

Nepali media often report a high prevalence of kidney failure in returnee Nepali migrant workers from GCC and Malaysia. It is unknown if these higher rates of kidney health-related problems are due to the natural rise in number in a country with a huge number of the population migrated for work or whether there is an increased risk compared to the general Nepali population due to the working and living conditions in abroad. Medical treatment of kidney health-related problems in Nepal is limited and expensive, especially in end stage renal disease (ESRD), where renal replacement therapies in the form of dialysis or renal transplantation are the only specific measures of management. This has huge financial implication to their family and could push them towards poverty.

In the recent years, the evidence is emerging that chronic or repeated episodes of heat stress accompanied by strenuous work and dehydration may trigger pre-renal acute kidney injury (AKI) that might eventually progress to CKD. This phenomenon has been mainly attributed to disproportionately higher CKD rates in agriculture workers in Central America, America, India, Sri Lanka, Thailand and in other countries. The vast majority of migrant workers in the countries of Gulf and Malaysia works in searing heat with intense physical exertion with less opportunity of regular rehydration. Thus, we speculate that this working condition may expose them to a higher risk of kidney injuries and subsequent CKD.

There is no reporting system to understand the health issues of returnee migrants in Nepal nor do hospitals keep a record of their patients by migrant status. Though many studies among Nepali migrants report wide-ranging health and wellbeing issues, none of them reported the kidney health-related problems while abroad or after their return. At this backdrop, the specific objectives of this study were to explore the magnitude of the kidney health-related problems in returnee Nepali migrant workers via nephrologists and to assess the need for any further scientific investigation.

For further information: Please contact Dr. Nirmal Aryal (nirmal.aryal.2010@gmail.com) or Dr. Arun Sedhain (arunsedhain@gmail.com)