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CKD of undetermined aetiology: Tens of thousands of premature deaths yet too many unknowns remain

Mahalingasivam, V; Caplin, B; (2019) CKD of undetermined aetiology: Tens of thousands of premature deaths yet too many unknowns remain. Nephrology Dialysis Transplantation , 34 (11) pp. 1839-1841. 10.1093/ndt/gfz014. Green open access

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Abstract

Tens of thousands of working-age adults have been dying from unexplained end-stage renal disease (ESRD) in Central America and South Asia. As the cause of this chronic kidney disease (CKD) remains unknown, the condition(s) (a unified aetiopathology has not been confirmed) has been termed ‘CKD of undetermined aetiology’ (CKDu). ‘CKD of non-traditional aetiology’, ‘chronic interstitial nephritis in agricultural communities’, ‘Mesoamerican nephropathy’, ‘Sri Lankan agricultural nephropathy’ and ‘Uddanam nephropathy’ are also used, but here we use the term CKDu. The first reports of CKDu, almost 20 years ago, were based on observations of an excess of working-age adults from agricultural communities in El Salvador and Sri Lanka receiving dialysis, but without a diagnosis explaining their ESRD [1, 2]. Available population-level data now support a high prevalence of renal dysfunction in the absence of known risk factors in Central America and South Asia [3–5], but the global extent of the problem remains unclear (Figure 1). Lack of access to renal replacement therapy (RRT) in many affected areas means that death from ESRD is common.

Type: Article
Title: CKD of undetermined aetiology: Tens of thousands of premature deaths yet too many unknowns remain
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/ndt/gfz014
Publisher version: https://doi.org/10.1093/ndt/gfz014
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Renal Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10068616
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