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Abstract
Chronic kidney disease of unknown origin (CKDu) is a global burden among the agricultural communities, this is a non-communicable disease (NCD) which is asymptomatic and irreversible until latter stages of the disease. The disease has no common features unlike chronic kidney diseases (CKD’s) making early detection impossible in the patients. The most recent form of CKDu was reported in India, known as the Indian CKDu in late 2010’s. In Sri Lanka, CKDu is highly prevalent in the north central province of the country with nearly15.1%-22.9% presented with the disease. This region is a dry-zone in which agricultural and farming activities are carried out as the main occupation. Several studies have been carried out linking CKDu to various factors such as heavy metals in water, agrochemicals, heat, dehydration and socio-demographics in NCP. Despite several researches being conducted none of them were able to prove the root cause and causative factors of the disease. Using the available articles online, studies from countries such as India, Nicaragua, Sri Lanka and South America were chosen in which heat stress, dehydration, heavy metal involvement, agrochemicals were common causative factors reported in these geographical locations. Several studies analyzed indicate that the affected CKDu population were part of the agricultural community in rural areas with less or no proper high school education and family history with CKDu. Recent findings do suggest that a combination study involving socio-demographical data and geographical data will help to end the CKDu debate worldwide and provide new insights into early diagnosis.
Highlights
Chronic kidney disease’s is one of the growing health concerns globally, it is ranked as the 12th most common cause of death by the Global Burden of Disease Study and a reported 1.1 million patients die yearly due to kidney failure and a reported 5-10 million people die due to any form of CKD
Read by QxMD tool was used to search for the keywords “chronic kidney disease of unknown origin (CKDu)”, “CKD”, “North Central Province”, “heavy metals”, “Mesoamerican nephropathy (MEN)”, “e-GFR”, “agrochemicals” were combined with “Sri Lanka”, “Lanka” and “SL”
CKDu is a form of CKD which is a growing concern in the North Central Province (NCP) of Sri Lanka, several hypotheses have been suggested and studies have been conducted widely to understand the impact of the disease
Summary
Chronic kidney disease’s is one of the growing health concerns globally, it is ranked as the 12th most common cause of death by the Global Burden of Disease Study and a reported 1.1 million patients die yearly due to kidney failure and a reported 5-10 million people die due to any form of CKD. The first case of CKDu was reported back in 1912, known as the Itai-itai disease in Japan which commonly affected postmenopausal women, the etiology was unknown until 1968 where cadmium was identified as the main causative agent. Disease being asymptomatic until end-stage-renal-disease (ESRD), severity higher in males than females, main occupation as farming are the common resemblances between MEN, SL-CKDu and Indian-CKDu. Several studies have been conducted over the past decade to identify the root cause for the Sri Lankan. CKDu, environmental and occupational hazards have been identified as the most common features presented among MEN, Indian-CKDu and Sri Lankan CKDu. Heavy metal contamination, use of agrochemicals, heat and dehydration, snake bites and occupational health hazards have been identified as the potential causes of CKDu. the underlying etiologies have not been identified in most places such as the NCP of Sri Lanka. By analyzing the available evidence from existing literature papers, the potential causative factors can be identified and provide better insights into Sri Lankan CKDu [3]
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