There are unconfirmed reports of long hour drivers in hot City of Dire Dawa- Ethiopia and there have been 10 renal failure cases based on hospital data and as a coincidence all of these cases happened to be taxi drivers and all operate similar vehicles. Recently people are inclined to make an association between driving that particular machine following a report of deaths of two drivers due to bilateral renal failure. It occurred to me that having an objective explanation to the coincidence or establishing a valid correlation might help.
Interesting cases! The main cause I could think is dehydration (ECF volume depletion) because of the hot weather. The one question, I have is that were any of these patients were on agents that block or inhibit the Renin-angiotensin system - ACE-inhibitors or ARBs, as the risk of renal failure is significantly higher in such patients, if for any reason they get dehydrated.
The other possibility is of rhabdomyolysis, because of possibly bumpy rides [not clear if that is the case in Ethiopia, but believe so and I may be wrong] and this resulted in myoglobin precipitation in the tubules causing ATN and renal failure. Has any of those had Creatine Kinase measured?
Thank you very much Sir I will come up with what I find out regarding any findings of their lab investigations.
Renal failure can be due to Acute Kidney Injury ( AKI ) or Chronic Kidney Disease ( CKD ) . Drivers who have Diabetes , Hypertension or pre existing CKD & are irregular in taking their regular drugs , due to long working hours can develop progression of renal disease rapidly . They can consume NSAIDs due to body ache from tiring physical work leading to AKI or AKI on CKD . It is essential that these group of persons undergo regular screening for their health , so that they are not a risk to themselves & to other road users . The other reasons for renal failure suggested by Malvinder Parmar are also significant
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