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 ORIGINAL ARTICLE
Year : 2015  |  Volume : 25  |  Issue : 5  |  Page : 274-280

Endemic chronic kidney disease of unknown etiology in Sri Lanka: Correlation of pathology with clinical stages


1 Department of Pathology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
2 Department of Nephrology and Transplant Unit, Teaching Hospital, Kandy, Sri Lanka
3 Nephrology Unit, General Hospital, Kurunagala, Sri Lanka

Correspondence Address:
S Wijetunge
Department of Pathology, Faculty of Medicine, University of Peradeniya, 20400
Sri Lanka
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-4065.145095

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Chronic kidney disease of unknown etiology (CKDU) is endemic among the rural farming communities in several localities in and around the North Central region of Sri Lanka. This is an interstitial type renal disease and typically has an insidious onset and slow progression. This study was conducted to identify the pathological features in the different clinical stages of CKDU. This is a retrospective study of 251 renal biopsies identified to have a primary interstitial disease from regions endemic for CKDU. Pathological features were assessed and graded in relation to the clinical stage. The mean age of those affected by endemic CKDU was 37.3 ± 12.5 years and the male to female ratio was 3.3:1. The predominant feature of stage I disease was mild and moderate interstitial fibrosis; most did not have interstitial inflammation. The typical stage II disease had moderate interstitial fibrosis with or without mild interstitial inflammation. Stage III disease had moderate and severe interstitial fibrosis, moderate interstitial inflammation, tubular atrophy and some glomerulosclerosis. Stage IV disease typically had severe interstitial fibrosis and inflammation, tubular atrophy and glomerulosclerosis. The mean age of patients with stage I disease (27 ± 10.8 years) was significantly lower than those of the other stages. About 79.2%, 55%, 49.1% and 50% in stage I, II, III and IV disease respectively were asymptomatic at the time of biopsy.






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Indian Journal of Nephrology
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Online since 20th Sept '07