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"ABSTRACTThis study was to determine albuminuria prevalence and risk associations of albuminuria in people who lived in Klong Luang community. This cross-sectional study was conducted in Klong Luang community, Pathum Thani province, Thailand. The mid-stream urine and blood samples were collected from all participants for albuminuria testing with urine strip and blood urea nitrogen and creatinine analysis, respectively. Binary logistic regression was used for risk association analysis. Among 239 participants enrolled, 32 (13.4%) subjects had albuminuria. Creatinine was a significantly independent risk association for albuminuria (p<0.045, α=0.05). Participants who lived in this community were 13.4% albuminuria prevalence and creatinine was an independent risk association for albuminuria. Thus, Primary Health Care Services should follow up subjects with albuminuria and provide health education program to the Klong Luang community."

"Nefropati diabetik merupakan komplikasi DM tipe 2 yang umumnya ditandai dengan kondisi albuminuria dari hasil penilaian UACR. TGF-β1 urin merupakan faktor pertumbuhan yang banyak dikaitkan dengan patologis dari kerusakan ginjal pada nefropati diabetik. Tujuan dari penelitian ini yaitu untuk mengetahui hubungan nilai UACR dengan kadar TGF-β1 urin pada pasien DM tipe 2. Desain studi pada penelitian ini yaitu cross sectional dimana pengambilan sampel menggunakan teknik consecutive sampling. Sampel yang diperoleh berjumlah 99 subjek penelitian (62 pasien DM normolbuminuria, 27 pasien DM albuminuria, dan 10 subjek non DM sebagai kontrol) di Puskesmas Kecamatan Pasar Minggu. Kadar TGF-β1 urin diukur menggunakan ELISA, sedangkan nilai UACR diperoleh dari hasil uji laboratorium klinik. Hasil dari uji beda rerata pada kadar TGF-β1 urin menunjukkan tidak terdapat perbedaan bermakna (p = 0,790) pada ketiga kelompok sampel. Hasil analisis hubungan kadar TGF-β1 urin dengan nilai UACR pada kelompok DM normoalbuminuria dan albuminuria juga menunjukkan tidak adanya hubungan yang bermakna (r = -0,079; p = 0,462). Hal ini diduga adanya pengaruh tekanan darah dan konsumsi obat antihipertensi yang berpotensi mempengaruhi kadar TGF-β1 urin. Oleh karena itu, dapat disimpulkan bahwa kadar TGF-β1 urin dengan nilai UACR tidak terdapat hubungan yang signifikan pada pasien DM tipe 2.

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Diabetic nephropathy is one of type 2 DM complication that can be detected by UACR (Urine Albumin Creatinine Ratio) as a marker for albuminuria condition. Urinary transforming growth factor β1 (TGF-β1) is a growth factor related to pathology of kidney disease in nepropathy diabetic. The aim of the present study was to know the correlation between TGF-β1 and UACR in type 2 DM patients. Design study was using cross sectional with consecutive sampling method. The study was performed in 99 subjects (62 DM normolbuminuria patients, 27 DM albuminuria patients, and 10 non DM subject as controls) at Pasar Minggu Community Health Center. Urinary TGF-β1 level was measured by ELISA, and UACR was measured in clinical laboratory. The result of mean difference test showed that urinary TGF-β1 level (p = 0,790) difference were not present in three group samples. Analysis correlation urinary TGF-β1 level and UACR in DM normoalbuminuria and albuminuria groups did not show correlation (r = -0,079; p = 0,462), and the result might influenced by blood pressure and received antihypertention medication that potent to reduce urinary TGF-β1 level. In conclusion, urinary TGF-β1 level and UACR did not have significant correlation in type 2 DM patients."

"Latar Belakang: Acute Kidney Injury pada COVID-19 merupakan komplikasi penting dan dikaitkan dengan peningkatan risiko kematian diduga diperantarai kondisi inflamasi dan disregulasi imun, baik di awal maupun selama perawatan. Tujuan: Untuk mengetahui hubungan antara IL-6, IL-10, TNF-" dengan AKI dan memprediksi perburukan hematuria, dan kejadian AKI Metode: Studi potong lintang dan prospektif kohort melibatkan 43 pasien COVID-19 derajad sedang dan berat yang dirawat di Rumah Sakit Pertamina Pusat di Jakarta, Indonesia dari bulan November 2020 hingga Januari 2021. Selama observasi dilakukan pemeriksaan darah lengkap, serum kreatinin, urinalisis, kadar IL-6, IL-10, TNF-" pada hari pertama dan hari ketujuh pengobatan atau sebelum hari ketujuh jika pasien meninggal atau dipulangkan, dan perubahannya di analisis. Insiden AKI ditentukan ketika perubahan serum kreatinin dan urin output memenuhi kriteria pedoman Kidney Disease Improving Global Outcomes. Uji korelasi dilakukan terhadap peningkatan sitokin dengan perubahan hematuria dan kreatinin. Uji Wilcoxon dilakukan untuk mengetahui perbedaan kadar sitokin diantara status albuminuria. Selanjutnya dilakukan uji Receiver Operator Characteristic untuk melihat kemampuan prediksi IL-6, IL-10, TNF-" terhadap perburukan hematuria dan kejadian AKI, menggunakan AUC minimal 0,7 dengan batas bawah IK 95% lebih dari 0,5 dan nilai p <0,05 Hasil: Terdapat korelasi antara peningkatan kadar serum IL-10 dengan perubahan serum kreatinin (r= -0,343; p 0,024) tetapi tidak pada perubahan IL-6 dan TNF-a. Perubahan hematuria tidak berkorelasi dengan peningkatan ketiga kadar sitokin. Juga tidak ada perbedaan dalam kadar sitokin di antara kelompok albuminuria. Kadar serum TNF-" dihari pertama perawatan dapat memprediksi AKI pada hari ke tujuh, AUC 85%; p=0,045 (IK 0,737-0,963), tetapi tidak dapat memprediksi perburukan hematuria Kesimpulan: Terdapat korelasi antara peningkatan IL-10 dengan perubahan serum kreatinin. TNF-! pada hari pertama perawatan dapat memprediksi kejadian AKI di hari ketujuh perawatan pasien COVID-19 derajat sedang dan berat.

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Background: Acute Kidney Injury is an important complication and is associated with increased risk of death in COVID-19 due to inflammatory conditions and immune dysregulation, both at the beginning and during treatment. Aim: To determine the relationship between IL-6, IL-10, TNF-α with AKI and their ability to predict the worsening of hematuria, and the incidence of AKI. Methods: 43 moderate and severe COVID-19 patients treated from November 2020 to January 2021 at Pertamina Central Hospital in Jakarta, Indonesia were included in this cross-sectional and prospective cohort study. During observation, tests including complete blood count, serum creatinine, urinalysis, levels of IL-6, IL-10 and TNF-α were performed on the first and seventh day of treatment, or before day 7 if the patient died or was discharged, and the changes were analyzed. The incidence of AKI is determined when changes in serum creatinine and urine output meet the criteria in the Kidney Disease Improving Global Outcomes guidelines. Correlation test was performed on increased cytokines with changes in hematuria and creatinine. Wilcoxon test was performed to obtain differences in cytokine levels among albuminuria status. Receiver Operator Characteristic test was then carried out to see the predictive ability of IL-6, IL-10, TNF- α on the worsening of hematuria and the incidence of AKI. Results: There was a correlation between increased serum IL-10 levels with changes in serum creatinine (r= -0.343; p 0.024), but not in IL-6 and TNF-a levels. On the other hand, changes in hematuria did not correlate with an increase in the levels of the three cytokines. There was also no significant difference in the levels of cytokines among albuminuria groups. Serum TNF-! levels on the first day of treatment were able to predict AKI on the seventh day (AUC 85%; p=0.045; 95%CI 0.737-0.963), but did not predict the worsening of hematuria. Conclusion: There was a correlation between increased serum IL-10 with changes in serum creatinine. TNF-! on the first day of treatment can predict the incidence of AKI on the seventh day of treatment for moderate and severe COVID-19 patients."

"Latar belakang: Ginjal merupakan target organ hipertensi yang cukup sering terjadi. Deteksi kerusakan ginjal menjadi salah satu hal yang direkomendasikan dalam penatalaksanaan hipertensi terbaru. Indeks resistif renalis IRR yang diperkenalkan pada beberapa dekade terakhir dipercaya dapat mendeteksi lebih awal kerusakan ginjal serta dapat mengevaluasi hasil pengobatan hipertensi yang diberikan. Penelitian terdahulu telah membuktikan terdapat hubungan antara nilai IRR dengan tekanan darah serta kejadian mikroalbuminuria pada populasi pasien hipertensi tidak terkontrol dan hipertensi resisten, tetapi hingga saat ini belum ada penelitian yang menilai hubungan tersebut pada hipertensi terkontrol. Tujuan: Mengetahui hubungan nilai IRR dengan kadar albuminuria pada pasien hipertensi terkontrol. Metode: Pasien hipertensi terkontrol akan menjalani pemeriksaan duplex renalis untuk mendapatkan nilai IRR. Luaran kerusakan ginjal sebagai target organ hipertensi dinilai dengan pemeriksaan albuminuria melalui rasio albumin kreatinin urin (UACR). Hasil: Terdapat 47 pasien yang menjadi subjek penelitian. Rerata nilai IRR pada subyek penelitian ini adalah 0,68 ± 0,07 dan rerata kadar UACR adalah 6,0 (1-122) mg/g. Tidak didapatkan hubungan yang bermakna antara nilai IRR dengan kadar albuminuria pada pasien hipertensi terkontrol (P=0,18 dengan nilai koefisien korelasi r=0,20). Faktor-faktor lain seperti usia, jenis golongan serta jumlah antihipertensi serta lama pengobatan hipertensi tidak berhubungan dengan kadar albuminuria. Kesimpulan: Nilai IRR tidak berhubungan dengan kadar albuminuria pada hipertensi terkontrol.

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Background: Kidney is a target organ hypertension is quite common. Detection of kidney damage is one of the things that is recommended in the management of recent hypertension. The renalis resistive index IRR introduced in the last few decades is believed to detect early kidney damage and can evaluate the results of treatment of hypertension given. Previous research has shown there is a correlation between RRI value with blood pressure and incidence of microalbuminuria in patient with uncontrolled and resistent hypertension, but until now there has been no study that assesses the relationship in patient with controlled hypertension. Objectives: To investigate the relationship between RRI value with albuminuria levels in patient with controlled hypertension.Methods: Patients with controlled hypertension will undergo duplex renalis examination to obtain an RRI score. The outcome of renal impairment as a target organ of hypertension was assessed by albuminuia examination through urine albumin creatinine ratio (UACR) Results: There were 47 patients who became the subject of the study. The average RRI value in this study subjects was 0.68 ± 0.07 and UACR value was 6,0 (1-122) mg/g. There was no significant relationship between IRR and albuminuria levels in hypertensive patients with controlled blood pressure (P = 0.18 with correlation coefficient r = 0.20). Other factors such as age, class type and number of antihypertensives and length of treatment of hypertension are not associated with albuminuria levels. Conclusion: RRI values has no relationship with albuminuria levels in patient with controlled hypertension. "

"ABSTRAKBackground Gout arthritis associates with many comorbodities such as hyperuricemia, hypertension, hyperglycemia, obesity, and dyslipidemia, which are also factors for the development of/or predisposition factors of chronic kidney diseases . Albuminuria is a predictor factors for CKD. Screening for albuminuria is needed to be done in patients with high risk of CKD. This research was conducted to examine the prevalence of albuminuria and the associated factors in gout arthritis patients.Methods This research was a cross sectional study from gout arthritis patients medical records in Cipto Mangunkusumo Hospital. We included all gout patients who treated within 2011 until 2015. Subjects with chronic kidney disease, in kidney replacement therapy, hypertension > 10 years, and diabetes > 5 years were excluded. Albuminuria was determined by urine dipstick result of protein > 1. Factors associated were age, sex, hyperuricemia, hypertension, stage of hypertension, hyperglycemia, obesity, dyslipidemia, uric acid level, and body mass index. Data associated with the factors were recorded and the associations were tested with chi square, fisher exact, or independent t test.Results from 54 subjects included in this research, the prevalence of albuminuria was 20.4 percent . There were no significant associations between all factors and albuminuria tested by chi square and fishers exact test. Independent t tests results also showed no significant associations between all the factors and albuminuria Conclusion The prevalence of albuminuria in gout arthritis patient was 20.4 percent. There were no significant associatons between age, sex, hyperuricemia, hypertension, hyperglycemia, obesity, dyslipidemia, uric acid level, and body mass index tested with albuminuria in gout arthritis patients in Cipto Mangunkusumo Hospital from 2011 until 2015."

"ABSTRAKDalam satu dekade terakhir, para peneliti berfokus dalam upaya penemuan biomarker proteindan peptida untuk penyakit ginjal diabetik. Reviewini bertujuan untuk menelusuri, menelaah, dan mensintesisterkaitperkembangan terkini protein dan peptida sebagai biomarker untuk penyakit ginjal diabetik. Penelusuranliteratur dilakukan secara sistematis dengan melakukan penelusuran studi observasionalpada databaseseperti Sciencedirect, Springerlink, dan PubMed yang dipublikasikan dari Januari 2018 hingga April 2020. Setelah melakukan proses penyaringan, terdapat 20 artikel penelitian yang memenuhi kriteria inklusi yang telah ditetapkan. Berdasarkan literatur tersebut, biomarker protein dan peptida yang ditemukan menunjukkan hasil yang menjanjikan untuk memprediksi penyakit ginjal diabetik. Biomarker baru diklasifikasikan ke dalam beberapa kelompok berdasarkan peran biomarker dalam mekanisme patogenesis penyakit ginjal diabetik, seperti biomarker pada glomerulus (ANGPTL4, beta-2 microglobulin, Smad1, dan glypican-5), biomarker inflamasi (MCP-1 dan adiponectin), dan biomarker pada tubulus (NGAL, VDBP, megalin, sKlotho, dan KIM-1). Selain itu, pengembangan panel biomarker diduga memiliki potensi yang lebih baik dibandingkan biomarker tunggaldalam diagnosis penyakit ginjal diabetik. Semua biomarker yang dibahas pada review ini menunjukkan hubungan dengan albuminuria dan nilai eLFG. Namun, belum ada biomarker baru yang memiliki kemampuan prognosismelebihi albuminuria ataupun nilai eLFG. Hingga saat ini penggunaan biomarker protein dan peptida baru pada praktik klinis masih sangat terbatas.

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ABSTRACT

In the past decade, researchers are focused on the discovery of protein and peptide biomarkers for diabetic kidney disease (DKD). This paper aims to search, analyze, and synthesizethe current updates regarding the development of proteins and peptides as biomarkers for DKD. We systematically searched ScienceDirect, Springerlink, and PubMed (January 2018 until April 2020) databases for observational studies of protein and peptide biomarkers in patients with diabetes mellitus. Following the screening process, only 20 research articles met the inclusion criteria. Protein and peptide biomarkers found showed promising results for predicting DKD. These biomarkers include glomerular biomarkers (ANGPTL4, beta-2microglobulin, Smad1, and glypican-5), inflammatory biomarkers (MCP-1 and adiponectin), and tubular biomarkers (NGAL, VDBP, megalin,sKlotho,and KIM-1). Besides, the developmentof a panel biomarker showed a more promising result than a single biomarker at diagnosing DKD. All biomarkers discussed in this review correlate with albuminuria and eGFR. However, there's still no biomarker that has a prognostic value beyond albuminuria or eGFR. Until now, the use of biomarker proteins and peptides in clinical practice is still very restricted."

"Tujuan: mengembangkan sistem skor dan menentukan nilai tambah diagnostik albuminuria dalam mengestimasi carotid intima-media thickness (CIMT). Metode: studi potong lintang dilakukan di poliklinik endokrin RSCM bulan Maret-Mei 2012 pada pasien DMT2 tanpa komplikasi serebrokardiovaskular, penyakit ginjal kronis (PGK) stadium ≥ III, dan tidak merokok. Kami melakukan analisis statistik yang dilanjutkan dengan pembuatan sistem skor. Hasil: dari 71 subjek, didapatkan CIMT dan albuminuria masing-masing sebesar 67,6% dan 73,3%. Dari 48 subjek dengan CIMT, sebanyak 87,5% mengalami albuminuria. Pemeriksaan albuminuria memiliki sensitivitas sebesar 87,5%. Penambahan nilai albuminuria akan meningkatkan AUC sebesar 2,3%. Skor estimasi untuk variabel lama terdiagnosis DM, hipertensi, dislipidemia berturut-turut sebesar 1, 2, 1. Skor probabilitas CIMT pada skor <2, 2, dan >2 sebesar 15%, 57%, dan 90%. Kesimpulan: pemeriksaan albuminuria meningkatkan nilai tambah diagnostik CIMT. Sistem skor dapat digunakan sebagai alat skrining terhadap CIMT pada pasien DM tipe 2 tanpa komplikasi serebrokardiovaskular, PGK stadium ≥ III, dan tidak merokok.

Aim: to develop a scoring system and measure the diagnostic added value of albuminuria to estimate CIMT. Methods: cross-sectional study was done in Endocrine Outpatient Clinic Cipto Mangunkusumo Hospital between March-May 2012 in T2DM patients without history of cerebrocardiovascular event, CKD stage ≥ III, and smoking.

Bivariate analysis and multivariate (logistic regression) analysis was done, followed by developing the scoring system. Results: from 71 subjects, there were 67.6% with increased CIMT and 73.3% with albuminuria. From 48 subjects with increased CIMT, 87.5% had albuminuria. Albuminuria measurement had high sensitivity (87.5%).

Adding albuminuria measurement will increase the AUC as 2.3%. Estimation score for duration of DM, hypertension, dyslipidemia were as follows 1, 2, 1 respectively. Probability score of increased CIMT for score <2, 2, and >2 was as follows 15%, 57%, and 90%. Conclusion: albuminuria measurement increase the diagnostic value of CIMT.

Scoring system can be used as a screening tool to estimate the increased of CIMT in type 2 DM patients without history of cerebrocardiovascular event, CKD stage ≥ III, and smoking"

"Nefropati diabetik telah diketahui merupakan salah satu penyulit jangka panjang diabetes melitus (DM) yang berbahaya, yang dapat menyebabkan kegagalan ginjal tahap akhir. Namun, data adanya nefropati diabetik di antara pasien diabetes tipe 2 yang menjalani rawat jalan saat ini belum ada. Penelitian cross-sectional ini ditujukan untuk mengetahui prevalensi nefropati diabetik di antara penderita diabetes tipe 2 rawat jalan yang datang untuk pertama kalinya ke Klinik Metabolik dan Endokrinologi, RSUPN Dr. Cipto Mangunkusumo, Jakarta. Dari Desember 2001 sampai Juni 2002, 100 pasien baru diabetes tipe 2 diikutsertakan dalam studi. Empat puluh dua di antaranya adalah laki-laki dengan usia rata-rata 54 + 9,6 tahun. Overt nephropathy (makroalbuminuria) ditemukan pada 11% pasien, incipient nephropathy (mikroalbuminuria) terdapat pada 26% penderita, sedangkan sisanya normal (normoalbuminuria). Hasil penelitian menunjukkan bahwa lama sakit yang lebih dari 5 tahun menunjukkan korelasi bermakna dengan derajat albuminuria. Namun, tidak ada hubungan bermakna antara derajat albuminuria dengan faktor-faktor risiko lain, yaitu usia, dislipidemia, hipertensi, obesitas, dan kadar HbA1c. Semua pasien dengan overt nephropathy menunjukkan tes klirens kreatinin di bawah 75 ml/ menit (rerata 45,3 mL/menit), secara bermakna lebih rendah dari pasien dengan mikro- atau normoalbuminuria (p=0,01). Retinopati ditemukan pada 10 dari 11 (90%) pasien dengan overt nephropathy. Analisis multivariat memperlihatkan bahwa lama sakit dan retinopati secara bermakna berkorelasi dengan terjadinya nefropati diabetik (p < 0,05). Sebagai kesimpulan dapat dikatakan bahwa prevalensi nefropati diabetik (yaitu overt nephropathy dengan retinopati) di antara pasien diabetes tipe 2 rawat jalan adalah 10%. Lama sakit merupakan faktor risiko penting bagi timbulnya penyulit ini. (Med J Indones 2004; 13: 161-5)

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Diabetic nephropathy has been known as one of the most serious long-term complications of diabetes mellitus (DM), which could lead to end-stage kidney failure. However, data showing the presence of diabetic nephropathy among ambulatory type 2 diabetic patients is currently not available. This cross-sectional study was conducted to find the prevalence of diabetic nephropathy among non-hospitalized type 2 diabetic patients, who came for the first time to the Metabolic and Endocrinology Clinic, Dr. Cipto Mangunkusumo Hospital, Jakarta. From December 2001 to June 2002, 100 new type 2 diabetic patients were included in the study. Forty-two of them were men and the mean age was 54 + 9.6 years. Overt nephropathy (macroalbuminuria) was found in 11% of patients, while incipient nephropathy (microalbuminuria) was 26%, and the rest were normal (normoalbuminuria). Duration of illness of more than 5 years was significantly correlated with the degree of albuminuria. However, there is no significant correlation between the degree of albuminuria and other risk factors, i.e. patient’s age, dyslipidemia, hypertension, obesity, HbA1c level. All patients with overt nephropathy had creatinine clearance test below 75 ml/ min. (mean 45.3 mL/min), significantly lower than patients with micro- or normoalbuminuria (p=0.01). Retinopathy was found in 10 out of 11 (90%) patients with overt nephropathy. Multivariate analysis showed that the duration of illness and retinopathy was significantly correlated with the presence of diabetic nephropathy (p< 0.05). We concluded that the prevalence of diabetic nephropathy (i.e. overt nephropathy with retinopathy) among non-hospitalized type 2 diabetic patients was 10%. The duration of illness was an important risk factor for the development of this complication. (Med J Indones 2004; 13: 161-5)"

"Studi eksperimental hewan memperlihatkan bahwa kadar vasopresin serum yang tinggi berhubungan dengan hiperfiltrasi, albuminuria dan hipertrofi glomerulus, dan dikhawatirkan berlanjut menjadi penurunan laju filtrasi glomerulus (LFG) dalam jangka panjang. Namun, belum terdapat laporan yang membuktikan hubungan sebab-akibat antara peningkatan vasopresin serum dengan gangguan ginjal. Studi ini bertujuan untuk mengetahui hubungan peningkatan vasopresin serum dengan gangguan ginjal, beserta lokasi gangguan ginjal tersebut. Studi ini juga ditujukan untuk melihat kemampuan berat jenis (BJ) urin untuk mendeteksi gangguan ginjal.Penelitian ini adalah studi potong lintang dengan consecutive sampling di sebuah pabrik sepatu pada bulan Januari–Maret 2020. Subjek adalah pekerja terpajan panas yang dinyatakan sehat berdasarkan medical checkup tahun 2019. Sampel darah dan urin diambil lima jam setelah subjek bekerja. Subjek diperiksakan kreatinin plasma, estimasi LFG berdasarkan CKD-EPI, BJ urin, albuminuria carik-celup, albumincreatinine ratio (ACR) urin, vasopresin serum, kidney injury molecule-1 (KIM-1) urin, dan nefrin urin. Data masa kerja, dan jenis kelamin diperoleh melalui wawancara.Pada studi ini, diperoleh 119 subjek wanita dengan median usia 38 (31–51) tahun dan median masa kerja 10 (3–14) tahun. Hiperfiltrasi didapatkan pada 18 subjek, LFG tidak menurun pada 104 subjek (87,4%), dan peningkatan nefrin urin pada 104 pekerja (87,4%). Tidak terdapat hubungan antara vasopresin meningkat dengan hiperfiltrasi, penurunan LFG, albuminuria, nefrin urin, dan KIM-1 urin. Terdapat hubungan bermakna antara peningkatan nefrin urin dengan masa kerja ≥ 10 tahun (p = 0,03). Terdapat hubungan peningkatan KIM-1 urin dengan albuminuria (p = 0,008). Terdapat area under the curve (AUC) antara BJ urin dan nefrin urin sebesar 81,7% (95% CI 68,8–94,6%), dengan titik potong BJ urin ≥ 1,018 yang memiliki sensitivitas 71,2% dan spesifisitas 80% untuk kenaikan nefrin.Sebagai simpulan, peningkatan vasopresin serum tidak berhubungan dengan hiperfiltrasi, penurunan LFG, albuminuria, dan peningkatan KIM-urin. Masa kerja > 10 tahun dihubungkan dengan peningkatan nefrin urin. BJ urin ≥ 1,018 dapat dijadikan acuan untuk mendeteksi kenaikan nefrin urin pada pekerja terpajan panas.

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Animal experimental studies have shown that high serum vasopressin levels are associated with hyperfiltration, albuminuria, and glomerular hypertrophy, which may lead to decreased glomerular filtration rate (GFR) in long-term. However, there was no earlier report that has established the causal relationship between elevated serum vasopressin and renal impairment. This study aims to determine the association between increased serum vasopressin and kidney impairments, along with the location of these impairments. This study is also aimed to look at the ability of urine specific gravity to detect elevated serum vasopressin and kidney impairments.This study was a cross-sectional study with consecutive sampling in a shoe factory from January–March 2020. Subjects were heat-exposed workers who were declared healthy based on the medical checkup in 2019. Blood and urine samples were taken five hours after the subject worked. Subjects were examined for plasma creatinine, estimated GFR (eGFR) based on CKD-EPI, urine specific gravity, dipstick albuminuria, urine albumin-creatinine ratio (ACR), serum vasopressin, urine kidney injury molecule-1 (KIM-1), and urinary nephrin. Data on age, length of service, and gender were obtained through interviews.There were 119 female subjects with a median age of 38 (31–51) years and a median length of service 10 (3–14) years. eGFR was not decreased in 104 subjects (87.4%) and urinary nephrin increased in 104 workers (87.4%). There were no increase in urinary albumin excretion and urinary KIM-1. There were significant association between increased urinary nephrin with length of service ≥ 10 years (p = 0.03), normal-increased eGFR with age 30–39 years (p = 0.001), and increased urinary KIM-1 with albuminuria (p = 0.008). There was an area under the curve (AUC) of 81.7% (95% CI 68.8–94.6%) between urine specific gravity and urinary nephrin, with a cut-off point of urine specific gravity > 1.018 having a sensitivity of 71.2% and a specificity of 80% for the increase in urinary nephrin.In conclusion, increased serum vasopressin does not cause a decrease in GFR, albuminuria, and increase in urinary KIM, but does cause an increase in urinary nephrin. urine specific gravity ≥ 1.018 can be used as a cut-off for detecting increased urinary nephrin in heat-exposed workers."