What is CKDu (chronic kidney disease of unknown cause)?
CKDu means chronic kidney disease of unknown cause.
Amongst the many threats to health in our world, the most challenging ones are the ones with unknown causes. There is a mysterious epidemic of kidney disease called chronic kidney disease of unknown aetiology (CKDu) that is occurring in many parts of the world.
Unrelated to known risk factors such as diabetes and hypertension, CKDu mostly affects the young and middle-aged, with slight preponderance in males. It mostly occurs in people living in rural areas, especially working in agricultural jobs.
Worldwide, the number of people with chronic kidney disease, and those who need dialysis and renal replacement, is increasing every year as compared to other chronic conditions like diabetes and AIDS.
Mesoamerican Nephropathy (MeN)
Of these regions where it has been investigated, much attention has been given to Sri Lanka and Central America (where it is called ‘Mesoamerican Nephropathy or MeN’).
In Central America, Nicaragua and El Salvador are two of the most affected countries, and workers on sugarcane plantations are found to be at highest risk.
Pathologically it is thought to be a chronic tubulo-interstitial nephritis.
But despite research and discussion spanning more than two decades, the cause for the nephropathy remains a mystery.
So. What ’causes’ CKDu?
Almost by definition, we do not know.
And, perhaps not surprisingly, there is a shortage of data on CKDu. However, data from the Indian CKD Registry revealed that CKDu is the second-most common underlying cause of CKD (16%) after diabetic nephropathy (31%).
CKDu has a multifactorial aetiology of different environmental and occupational exposures, such as heat stress, dehydration, agrochemicals (pesticides, herbicides, fertilisers), heavy metals (cadmium, lead, arsenic, etc.), water sources, and infections.
CKDu and dialysis
For these reason, it is not just alarming but a great challenge to healthcare systems across the world, especially in resource-poor countries. CKDu has become a silent killer for many patients.
The occurrence of end-stage renal disease (ESRD) in CKDu can be catastrophic for individuals, especially in countries with limited medical facilities, causing a significant socio-economic burden – as these countries do not have full access to free dialysis and transplantation care.
Even within these economically developing nations, people affected by CKDu usually are from the most vulnerable and underserved populations.
Summary
We have described what is CKDu. We hope it has been helpful.
Other resources
Is CKDu due to climate change?
There is more information here on CKDu in this review (Paidi et al, 2011).
Last Reviewed on 28 June 2024