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Official publication of the Indian Society of Nephrology
 
REVIEW ARTICLE
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Distribution and determinants of chronic kidney disease of unknown etiology: A brief overview


1 Departments of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
2 Department of General Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India

Correspondence Address:
P Stalin,
Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijn.IJN_313_18

Globally, 33187000 DALYs and 956000 deaths are attributed to chronic kidney disease (CKD) every year. Diabetes and hypertension are the two most common causes of CKD. Another category of CKD without any known common causes, chronic kidney disease of unknown etiology (CKDu) is also increasingly reported from different regions of the world such as Central America, Sri Lanka, and India. They are predominately observed in agricultural communities where crops such as sugarcane and coconut are commonly cultivated. Young adults and males are at higher risk of developing CKDu. It mainly affects individuals belonging to lower socioeconomic status. Exposure to silica, arsenic, and fluoride might be associated with increased prevalence of CKDu. The role of heat stress in contributing to CKD through dehydration is unclear but cannot be ruled out. Mycotoxins such as aflatoxins and ochratoxins are also found to be associated with CKDu in some settings. Several studies have reported that CKDu has a significant positive association with pesticides used in agriculture such as HCH, Endosulfan, Alachlor, and Pendimethalin. There is also a possible role of infections by Hantavirus and Leptospirosis in acute febrile phase of CKDu. However, there is no conclusive evidence from studies conducted on CKDu regarding its causes and risk factors. Therefore, large-scale studies with better methodology need to be conducted to study the etiology and pathogenesis of CKDu in various settings.


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    -  Stalin P
    -  Purty AJ
    -  Abraham G
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Indian Journal of Nephrology
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