Endemic Nephropathy Around the World
There have been several global epidemics of chronic kidney disease of unknown etiology (CKDu). Some, such as Itai-Itai disease in Japan and Balkan endemic nephropathy, have been explained, whereas the etiology of others remains unclear. In countries such as Sri Lanka, El Salvador, Nicaragua, and Ind...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-03-01
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| Series: | Kidney International Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2468024916301681 |
| _version_ | 1811194408194801664 |
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| author | Fiona J. Gifford Robert M. Gifford Michael Eddleston Neeraj Dhaun |
| author_facet | Fiona J. Gifford Robert M. Gifford Michael Eddleston Neeraj Dhaun |
| author_sort | Fiona J. Gifford |
| collection | DOAJ |
| description | There have been several global epidemics of chronic kidney disease of unknown etiology (CKDu). Some, such as Itai-Itai disease in Japan and Balkan endemic nephropathy, have been explained, whereas the etiology of others remains unclear. In countries such as Sri Lanka, El Salvador, Nicaragua, and India, CKDu is a major public health problem and causes significant morbidity and mortality. Despite their geographical separation, however, there are striking similarities between these endemic nephropathies. Young male agricultural workers who perform strenuous labor in extreme conditions are the worst affected. Patients remain asymptomatic until end-stage renal failure. Biomarkers of tubular injury are raised, and kidney biopsy shows chronic interstitial nephritis with associated tubular atrophy. In many of these places access to dialysis and transplantation is limited, leaving few treatment options. In this review we briefly describe the major historic endemic nephropathies. We then summarize the epidemiology, clinical features, histology and clinical course of CKDu in Mesoamerica, Sri Lanka, India, Egypt, and Tunisia. We draw comparisons between the proposed etiologies and supporting research. Recognition of the similarities may reinforce the international drive to establish causality and to effect prevention. |
| first_indexed | 2024-04-12T00:25:29Z |
| format | Article |
| id | doaj.art-71ae8c76f6634d9abc799ef4b0941a4b |
| institution | Directory Open Access Journal |
| issn | 2468-0249 |
| language | English |
| last_indexed | 2024-04-12T00:25:29Z |
| publishDate | 2017-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Kidney International Reports |
| spelling | doaj.art-71ae8c76f6634d9abc799ef4b0941a4b2022-12-22T03:55:31ZengElsevierKidney International Reports2468-02492017-03-012228229210.1016/j.ekir.2016.11.003Endemic Nephropathy Around the WorldFiona J. Gifford0Robert M. Gifford1Michael Eddleston2Neeraj Dhaun3Pharmacology, Toxicology & Therapeutics, University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UKPharmacology, Toxicology & Therapeutics, University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UKPharmacology, Toxicology & Therapeutics, University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UKPharmacology, Toxicology & Therapeutics, University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UKThere have been several global epidemics of chronic kidney disease of unknown etiology (CKDu). Some, such as Itai-Itai disease in Japan and Balkan endemic nephropathy, have been explained, whereas the etiology of others remains unclear. In countries such as Sri Lanka, El Salvador, Nicaragua, and India, CKDu is a major public health problem and causes significant morbidity and mortality. Despite their geographical separation, however, there are striking similarities between these endemic nephropathies. Young male agricultural workers who perform strenuous labor in extreme conditions are the worst affected. Patients remain asymptomatic until end-stage renal failure. Biomarkers of tubular injury are raised, and kidney biopsy shows chronic interstitial nephritis with associated tubular atrophy. In many of these places access to dialysis and transplantation is limited, leaving few treatment options. In this review we briefly describe the major historic endemic nephropathies. We then summarize the epidemiology, clinical features, histology and clinical course of CKDu in Mesoamerica, Sri Lanka, India, Egypt, and Tunisia. We draw comparisons between the proposed etiologies and supporting research. Recognition of the similarities may reinforce the international drive to establish causality and to effect prevention.http://www.sciencedirect.com/science/article/pii/S2468024916301681CKDuchronic kidney diseaseendemic nephropathy |
| spellingShingle | Fiona J. Gifford Robert M. Gifford Michael Eddleston Neeraj Dhaun Endemic Nephropathy Around the World Kidney International Reports CKDu chronic kidney disease endemic nephropathy |
| title | Endemic Nephropathy Around the World |
| title_full | Endemic Nephropathy Around the World |
| title_fullStr | Endemic Nephropathy Around the World |
| title_full_unstemmed | Endemic Nephropathy Around the World |
| title_short | Endemic Nephropathy Around the World |
| title_sort | endemic nephropathy around the world |
| topic | CKDu chronic kidney disease endemic nephropathy |
| url | http://www.sciencedirect.com/science/article/pii/S2468024916301681 |
| work_keys_str_mv | AT fionajgifford endemicnephropathyaroundtheworld AT robertmgifford endemicnephropathyaroundtheworld AT michaeleddleston endemicnephropathyaroundtheworld AT neerajdhaun endemicnephropathyaroundtheworld |