Asymptomatic Renal Function Abnormalities in Patients having Silicosis

Silicosis is one among the oldest occupational lung diseases known that is caused by inhalation, retention, and pulmonary reaction to the crystalline form of silica. A variety of occupational exposures are associated with the occurrence of silicosis, that is, mining, quarrying, cement, glass construction, ceramic, foundries, shipbuilding, rubber, cosmetic industries, jewelry, arts, crafts, sculpture, dental material, and many others.

Several studies for many years have drawn attention to renal dysfunction and nephrotoxicity among workers exposed to silica. This present study was conducted to evaluate renal dysfunction, if any, among Indian patients having silicosis and its correlation with the duration of exposure to silica dust.

This study included 52 eligible patients with a history of silica dust exposure and silicosis confirm on radiological examination. Investigations like serum creatinine, urinary albumin creatinine ratio, etc. were done. The "modification of diet in renal disease" (MDRD) formula was used to calculate the glomerular filtration rate (GFR).

This study showed 53.84% of patients having albuminuria and a mean "urinary albumin to creatinine ratio" (UACR) was also calculated. Isolated macroalbuminuria was detected in 11.5% of patients while 42.3% of patients presented with microalbuminuria.. They also identified a significant association between the duration of exposure to silica dust and urinary albumin to creatinine ratio and glomerular filtration rate.

Hence, the researchers concluded that albuminuria and reduced estimated glomerular filtration rate in patients with silica dust exposure is not uncommon and it reflects early underlying renal dysfunctions. This study suggests a simple and cost-effective screening strategy for early detection of renal dysfunction among silicosis patients that may be considered as a tool to prevent further renal damage in such patients.

Reference:

Dixit R, Jalutharia J, Goyal M. Asymptomatic Renal Function Abnormalities in Patients having Silicosis. J Assoc Physicians India 2022;70(11):49–52.