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Endemic Nephropathy Around the World.

Fiona J Gifford1, Robert M Gifford2, Michael Eddleston2

  • 1Pharmacology, Toxicology & Therapeutics, University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK; South Asian Clinical Toxicology Research Collaboration (SACTRC), University of Peradeniya, Peradeniya, Sri Lanka; Department of Renal Medicine, Royal Infirmary of Edinburgh, Edinburgh, UK.

Kidney International Reports
|April 4, 2017
PubMed
Summary

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Chronic kidney disease of unknown etiology (CKDu) affects young male agricultural workers globally. Identifying common factors across affected regions is crucial for prevention and treatment strategies.

Area of Science:

  • Nephrology
  • Epidemiology
  • Public Health

Background:

  • Global epidemics of chronic kidney disease of unknown etiology (CKDu) present significant public health challenges.
  • While some historical cases like Balkan endemic nephropathy are explained, many CKDu outbreaks remain of unclear origin.
  • CKDu is a major cause of morbidity and mortality in regions including Sri Lanka, Mesoamerica, and India.

Purpose of the Study:

  • To review major historic endemic nephropathies.
  • To summarize the epidemiology, clinical features, histology, and clinical course of CKDu in affected regions.
  • To compare proposed etiologies and research, aiming to establish causality and prevention.

Main Methods:

  • Literature review of historic endemic nephropathies.
Keywords:
CKDuchronic kidney diseaseendemic nephropathy

Related Experiment Videos

  • Summary of epidemiological data, clinical presentations, and histopathological findings of CKDu.
  • Comparative analysis of proposed etiologies and supporting evidence across different geographical areas.

    • Main Results:

    • CKDu disproportionately affects young male agricultural workers engaged in strenuous labor under harsh conditions.
    • Patients often remain asymptomatic until reaching end-stage renal failure, with elevated tubular injury biomarkers and chronic interstitial nephritis observed on biopsy.
    • Limited access to renal replacement therapy is common in affected areas.

    Conclusions:

    • Striking similarities exist among geographically disparate CKDu outbreaks, suggesting a common underlying etiology.
    • Understanding these similarities is vital for international efforts to determine the cause of CKDu.
    • Establishing causality will enable the development of effective prevention and intervention strategies for this debilitating disease.