Chronic kidney disease of undetermined origin may be common in tropical and subtropical rural areas

Chronic renal diseases of undetermined origin (CKDu), initially reported among agricultural communities in Central America and Sri Lanka, are also present in India, particularly in rural southern areas, and may be common in other tropical and subtropical rural environments. These are the main conclusions of a new study published in BMJ Open and in which participated the Institute of Global Health of Barcelona (ISGlobal), supported by "la Caixa".

CDKu is considered an epidemic in Central America and devastating in Nicaragua and El Salvador, where it mainly affects working-age populations of farming communities. CKDu is characterized by progressive loss of kidney function and is not badociated with diabetes or hypertension, the main causes of traditional chronic kidney disease. Its clinical course, a progressive loss of kidney function, tends to be faster than in other forms of CKD. The causes of the disease are unclear, but risk factors such as heat stress, arduous work, weather conditions, the use of agrochemicals or exposure to heavy metals have been suggested.

In this new study, researchers sought to determine whether CKDu is also present in India and to identify risk factors. To do this, they combined the cross-sectional data of 12,500 people from three population studies (CARRS, UDAY and ICMR-CHD) in the urban and rural areas of the North (Delhi and Haryana) and the South (Tamil Nadu and Andhra). Pradesh).

Participants had previously responded to questionnaires about eating habits, alcohol consumption, education level, and other socio-demographic data. Their body mbad index and blood pressure were also measured, as well as biomarkers of renal function.

The results indicate a 1.6% prevalence of the disease in adults under 60 years of age, but this figure varies considerably from one region to another and reaches its maximum in the rural areas of southern France. India where it reaches 4.8%. The main risk factors were being of working age (under 60), living in a rural area, consuming alcohol and less education.

Cristina O 'Callaghan, a researcher at ISGlobal and first author of the study, explains that "these risk factors are similar to those previously described in Central America and Sri Lanka." Exposure to potential disease risk factors, including agricultural work and exposure to agrochemicals, may be greater in rural areas.

These results have "important implications for global health because they indicate that CKDu could have a significant public health burden that has not been recognized before," concludes O. Callaghan.

She pointed out that "it is necessary to conduct other population studies in other tropical and subtropical countries to badess global trends in morbidity", such as the following. DEGREE study – an international collaboration for epidemiology of eGFR in low and middle income populations, led by Neil Pearce and Ben Caplin of the London School of Hygiene & Tropical Medicine (LSHTM) and University College London (UCL), which also participates in Cristina O 'Callaghan.