Scoping Review of Interventions to Prevent CKD of Unknown Origin in Working Populations

Chronic kidney disease (CKD) of unknown origin (CKDu) is a form of progressive kidney damage not attributable to traditional causes of CKD that has been observed primarily among agricultural workers in Central America and South Asia. The causes of CKDu remain an area of ongoing research. This scoping review aimed to summarize interventions used to prevent CKDu in working populations and to propose a comprehensive framework for future interventions.

A literature search across multiple databases was conducted on August 16, 2024 with an update on November 12, 2025. Articles that met the inclusion criteria were systematically assessed for quality, key elements of the interventions were extracted, and intervention quality was evaluated by 2 independent reviewers with a third serving as tiebreaker. Studies were graded using the Effective Public Health Practice Project (EPHPP) tool. Eight domains were used to evaluate intervention quality.

Eight articles met the final inclusion criteria. Four articles were graded as weak, 3 as moderate, and 1 as strong global quality. The interventions generally addressed water, rest, and shade (WRS). Most interventions addressed only 1 intervention quality domain, adoption. Few interventions addressed the domains of acceptability, appropriateness, cost, feasibility, fidelity, or penetration. No interventions addressed sustainability.

Few workplace interventions have been studied for their ability to prevent CKDu. Interventions that focused on WRS showed promising evidence for reducing CKDu incidence and progression, despite study quality concerns. The intervention studies were generally lacking in most domains of successful public health interventions.