CKDu: the known unknowns

Excerpt

Chronic kidney disease of uncertain aetiology (CKDu) is defined as an impairment of kidney function in the absence of a predisposing factor for kidney disease such as diabetes mellitus, chronic hypertension, snake bite with systemic envenomation, chronic glomerulonephritis or obstructive nephropathy [1]. Although commonly seen in Central America, patients with a similar clinical picture have also been reported in Sri Lanka, parts of India and the Balkan region. Meso-American nephropathy (MeN) refers to chronic kidney disease corresponding to a CKDu hotspot in the Pacific Coast lowlands of El Salvador, Nicaragua, Guatemala and Costa Rica [2]. Although first reported in young adult males involved in agriculture, there are emerging reports of CKDu in women and children in rural agricultural communities, challenging the aetiopathogenesis of this condition. …