2017
DOI: 10.1016/j.ekir.2016.11.003
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Abstract: 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 ma… Show more

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Cited by 122 publications
(103 citation statements)
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“…Low use of renal biopsy is a feature of other CKD epidemiology studies in developing countries . It is unknown whether chronic kidney disease of unknown origin (CKDu), which is associated with epidemics of ESKD in developing countries globally, is contributing to kidney disease in Fiji . Fiji shares risk factors for this disease, including high ambient temperatures, large agricultural workforce and concerns regarding drinking water quality, with countries experiencing epidemics of CKDu such as Mexico and Sri Lanka.…”
Section: Discussionmentioning
confidence: 99%
“…Low use of renal biopsy is a feature of other CKD epidemiology studies in developing countries . It is unknown whether chronic kidney disease of unknown origin (CKDu), which is associated with epidemics of ESKD in developing countries globally, is contributing to kidney disease in Fiji . Fiji shares risk factors for this disease, including high ambient temperatures, large agricultural workforce and concerns regarding drinking water quality, with countries experiencing epidemics of CKDu such as Mexico and Sri Lanka.…”
Section: Discussionmentioning
confidence: 99%
“…The incidence of chronic kidney disease among agricultural workers has increased globally, 31,32 including within the United States. 33,34 In recent years, an epidemic of chronic kidney disease of unknown etiology has gained increasing notice and is hypothesized to be associated with recurrent episodes of dehydration, volume depletion, and AKI caused by working in hot environments.…”
Section: Discussionmentioning
confidence: 99%
“…CKDu is a major public health threat causing significant morbidity and mortality affecting middle-aged men with more than 20,000 casualties in Mesoamerica areas and elsewhere with high mortality due to end-stage renal disease. However, despite their geographical separation, there are striking similarities between these endemic nephropathies [12]. On the other hand, leptospirosis affects a large proportion of population and is estimated to occur in adult men with age of 20-50 years, similar to regions of CKDu where agricultural workers were largely encountered.…”
Section: Ckd Hotspots Versus Leptospirosis Global Mapmentioning
confidence: 99%
“…CKD hotspots are observed with higher incidence of CKD and are distributed in different countries, regions, communities, or ethnicities [10,11]. Some have been explained of the cause of CKD, such as cadmium in Itai-Itai disease in Japan and aristolochic acid in Balkan nephropathy, whereas the etiology of many others remained unclear, therefore termed CKD of unknown etiology (CKDu) [12]. CKDu is a form of CKD that is not attributable to any traditional risk factor, such as diabetes, hypertension, or HIV.…”
Section: Ckd Hotspots Versus Leptospirosis Global Mapmentioning
confidence: 99%