Kidney health risk of migrant workers: An issue we can no longer overlook

The burden of kidney disease-related morbidity and mortality in the general population is rising. Recent data suggest that 1.2 million people worldwide lost their lives from Chronic Kidney Disease (CKD) in 2017. The global prevalence of CKD was estimated between 11% to 13%, according to a 2016 review. There exists a specific population group of low-skilled migrant workers in the countries of the Gulf and Malaysia, who could be at a disproportionately higher risk of kidney health problems. The working conditions often called as 3Ds (Dirty, Dangerous and Difficult) of these blue-coloured workers, such as physically demanding work, exposure to a hot environment, dehydration, chemical exposures, excessive use of pain killers, and lifestyle factors (such as less water intake, high intake of alcohol and sugary drinks) may precipitate them to acute kidney injuries and subsequent CKD. Anecdotal reports in Nepal also suggest a higher risk of kidney failure among returnee migrant workers. It is difficult to ascertain the prevalence of CKD for these migrant workers of their country due to the lack of a national registry or surveillance system. However, a systematic review including population-based studies of India, Nepal, Bangladesh, and Pakistan (labour migrant-sending countries to the Gulf and Malaysia) and using the Modification of Diet in Renal Disease (MDRD) equation estimated the prevalence of CKD between 10.6% (Nepal) to 23.3% (Pakistan).