348
Views
3
CrossRef citations to date
0
Altmetric
Review

Purposeful Review to Identify Risk Factors, Epidemiology, Clinical Features, Treatment and Prevention of Chronic Kidney Disease of Unknown Etiology

ORCID Icon
Pages 367-377 | Published online: 14 Dec 2020

References

  • Webster AC, Nagler EV, Morton RL, Masson P. Chronic kidney disease. Lancet. 2017;389(10075):1238–1252. doi:10.1016/S0140-6736(16)32064-527887750
  • Ene-Iordache B, Perico N, Bikbov B, et al. Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study. Lancet Glob Health. 2016;4(5):e307–19. doi:10.1016/S2214-109X(16)00071-127102194
  • Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major non-communicable diseases. Kidney Int. 2011;80(12):1258–1270. doi:10.1038/ki.2011.36821993585
  • Correa-Rotter R, Wesseling C, Johnson RJ. CKD of unknown origin in Central America: the case for a Mesoamerican nephropathy. Am J Kidney Dis. 2014;63(3):506–520. doi:10.1053/j.ajkd.2013.10.06224412050
  • Rodríguez MI. Sounding the alarm on chronic kidney disease in farming communities: María Isabel Rodríguez MD. Minister of health, El Salvador. Interview by Conner Gorry. MEDICC Rev. 2013;15(3):8.23934420
  • Rajapurkar MM, John GT, Kirpalani AL, et al. What do we know about chronic kidney disease in India: first report of the Indian CKD registry. BMC Nephrol. 2012;13(1):10. doi:10.1186/1471-2369-13-1022390203
  • Tuot DS, Zhu Y, Velasquez A, et al. Variation in patients’ awareness of CKD according to how they are asked. Clin J Am Soc Nephrol. 2016;11(9):1566–1573. doi:10.2215/CJN.0049011627340288
  • Herrera R, Orantes CM, Almaguer M, et al. Clinical characteristics of chronic kidney disease of nontraditional causes in Salvadoran farming communities. MEDICC Rev. 2014;16:39–48.24878648
  • Levin A, Stevens PE, Bilous RW, et al. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int Suppl. 2013;3(1):1–50.
  • Caplin B, Yang CW, Anand S, et al. The international society of nephrology’s international consortium of collaborators on chronic kidney disease of unknown etiology: report of the working group on approaches to population-level detection strategies and recommendations for a minimum dataset. Kidney Int. 2019;95(1):4–10. doi:10.1016/j.kint.2018.08.01930606428
  • Pan American Health Organization. Epidemic of chronic kidney disease in agricultural communities in Central America. Case definitions, methodological basis and approaches for public health surveillance. Washington, DC: Pan American Health Organization; 2017 Available from: http://iris.paho.org/xmlui/handle/123456789/34132. Accessed 1130, 2020.
  • Athuraliya NT, Abeysekera TD, Amerasinghe PH, et al. Uncertain etiologies of proteinuric-chronic kidney disease in rural Sri Lanka. Kidney Int. 2011;80(11):1212–1221. doi:10.1038/ki.2011.25821832982
  • Ramirez-Rubio O, McClean MD, Amador JJ, Brooks DR. An Epidemic of Chronic Kidney Disease in Central America: An Overview. 2013:123–125.
  • Fischer RS, Vangala C, Truong L, et al. Early detection of acute tubulointerstitial nephritis in the genesis of Mesoamerican nephropathy. Kidney Int. 2018;93(3):681–690. doi:10.1016/j.kint.2017.09.01229162294
  • Fischer RS, Mandayam S, Chavarria D, et al. Clinical evidence of acute Mesoamerican nephropathy. Am J Trop Med Hyg. 2017;97(4):1247–1256. doi:10.4269/ajtmh.17-026028722618
  • Fischer RS, Vangala C, Mandayam S, et al. Clinical markers to predict progression from acute to chronic kidney disease in Mesoamerican nephropathy. Kidney Int. 2018;94(6):1205–1216. doi:10.1016/j.kint.2018.08.02030466566
  • Senevirathna L, Abeysekera T, Nanayakkara S, et al. Risk factors associated with disease progression and mortality in chronic kidney disease of uncertain etiology: a cohort study in Medawachchiya, Sri Lanka. Environ Health Prev Med. 2012;17(3):191–198. doi:10.1007/s12199-011-0237-721881957
  • Jayasekara KB, Kulasooriya PN, Wijayasiri KN, et al. Relevance of heat stress and dehydration to chronic kidney disease (CKDu) in Sri Lanka. Prev Med Rep. 2019;1(15):100928. doi:10.1016/j.pmedr.2019.100928
  • Abeyagunawardena AS, Shroff R. CKDu: The Known Unknowns. Pediatric Nephrology (Berlin, Germany). 2020.
  • Jimenez CA, Ishimoto T, Lanaspa MA, et al. Fructokinase activity mediates dehydration-induced renal injury. Kidney Int. 2014;86(2):294–302. doi:10.1038/ki.2013.49224336030
  • Ratnayake S, Badurdeen Z, Nanayakkara N, Abeysekara T, Ratnatunga N, Kumarasiri R. Screening for chronic kidney disease of uncertain aetiology in Sri Lanka: usability of surrogate biomarkers over dipstick proteinuria. BMC Nephrol. 2017;18(1):199. doi:10.1186/s12882-017-0610-x28629425
  • De Silva PM, Mohammed Abdul KS, Eakanayake EM, Jayasinghe SS, Jayasumana C, Asanthi HB. Urinary biomarkers KIM-1 and NGAL for detection of chronic kidney disease of uncertain etiology (CKDu) among agricultural communities in Sri Lanka. PLOS Negl Trop Dis. 2016;10(9):e0004979. doi:10.1371/journal.pntd.000497927643785
  • Elledge MF, Redmon JH, Levine KE, Wickremasinghe RJ, Wanigasariya KP, Peiris-John RJ. Chronic kidney disease of unknown etiology in Sri Lanka: quest for understanding and global implications In: RTI Press Research Brief [Internet]. RTI press; 2014.
  • Gifford FJ, Gifford RM, Eddleston M, Dhaun N. Endemic nephropathy around the world. Kidney Int Rep. 2017;2(2):282–292. doi:10.1016/j.ekir.2016.11.00328367535
  • Abraham G, Varughese S, Thandavan T, et al. Chronic kidney disease hotspots in developing countries in South Asia. Clin Kidney J. 2016;9(1):135–141. doi:10.1093/ckj/sfv10926798474
  • Ramírez-Rubio O, Amador JJ, Kaufman JS, et al. Urine biomarkers of kidney injury among adolescents in Nicaragua, a region affected by an epidemic of chronic kidney disease of unknown aetiology. Nephrol Dial Transplant. 2016;31(3):424–432. doi:10.1093/ndt/gfv29226311057
  • Cuadra S, Hogstedt C, Jakobsson K, et al. Chronic kidney disease: assessment of current knowledge and feasibility for regional research collaboration in Central America. Available from: http://www.iret.una.ac.cr/Publications/01-0008.pdf.
  • Wesseling C, de Joode BV, Crowe J, et al. Mesoamerican nephropathy: geographical distribution and time trends of chronic kidney disease mortality between 1970 and 2012 in Costa Rica. Occup Environ Med. 2015;72(10):714–721. doi:10.1136/oemed-2014-10279926199395
  • Stanifer JW, Jing B, Tolan S, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. Lancet Glob Health. 2014;2(3):e174–81. doi:10.1016/S2214-109X(14)70002-625102850
  • Valcke M, Levasseur ME, da Silva AS, Wesseling C. Pesticide exposures and chronic kidney disease of unknown etiology: an epidemiologic review. Environ Health. 2017;16(1):49. doi:10.1186/s12940-017-0254-028535811
  • Wesseling C, Aragón A, González M, et al. Heat stress, hydration and uric acid: a cross-sectional study in workers of three occupations in a hotspot of Mesoamerican nephropathy in Nicaragua. BMJ Open. 2016;6(12):e011034. doi:10.1136/bmjopen-2016-011034
  • Jayasekara JM, Dissanayake DM, Adhikari SB, Bandara P. Geographical distribution of chronic kidney disease of unknown origin in North Central Region of Sri Lanka. Ceylon Med J. 2013;58(1):6–10. doi:10.4038/cmj.v58i1.535623549716
  • Nanayakkara S, Stmld S, Abeysekera T, et al. An integrative study of the genetic, social and environmental determinants of chronic kidney disease characterized by tubulointerstitial damages in the North Central Region of Sri Lanka. J Occup Health. 2013;13–0172.
  • Beker BM, Corleto MG, Fieiras C, Musso CG. Novel acute kidney injury biomarkers: their characteristics, utility and concerns. Int Urol Nephrol. 2018;50(4):705–713. doi:10.1007/s11255-017-1781-x29307055
  • Health (US), Centers for Disease Control, Prevention (US), Human Services Dept (US). editors. NIOSH Criteria for a Recommended Standard: Occupational Exposure to Heat and Hot Environments. National Institute on Drug Abuse; 2018.
  • Crowe J, Nilsson M, Kjellstrom T, Wesseling C. Heat‐related symptoms in sugarcane harvesters. Am J Ind Med. 2015;58(5):541–548. doi:10.1002/ajim.2245025851165
  • Lundgren K, Kuklane K, Gao C, Holmer I. Effects of heat stress on working populations when facing climate change. Ind Health. 2013;51(1):3–15. doi:10.2486/indhealth.2012-008923411752
  • Wesseling C, Crowe J, Hogstedt C, Jakobsson K, Lucas R, Wegman DH. Resolving the enigma of the mesoamerican nephropathy: a research workshop summary. Am J Kidney Dis. 2014;63(3):396–404. doi:10.1053/j.ajkd.2013.08.01424140367
  • Venkatachalam MA, Weinberg JM, Kriz W, Bidani AK. Failed tubule recovery, AKI-CKD transition, and kidney disease progression. J Am Soc Nephrol. 2015;26(8):1765–1776. doi:10.1681/ASN.201501000625810494
  • Glaser J, Lemery J, Rajagopalan B, et al. Climate change and the emergent epidemic of CKD from heat stress in rural communities: the case for heat stress nephropathy. Clin J Am Soc Nephrol. 2016;11(8):1472–1483. doi:10.2215/CJN.1384121527151892
  • Jayasumana C, Orantes C, Herrera R, et al. Chronic interstitial nephritis in agricultural communities: a worldwide epidemic with social, occupational and environmental determinants. Nephrol Dial Transplant. 2017;32(2):234–241.28186530
  • Redmon JH, Elledge MF, Womack DS, et al. Additional perspectives on chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka–lessons learned from the WHO CKDu population prevalence study. BMC Nephrol. 2014;15(1):1. doi:10.1186/1471-2369-15-12524386889
  • Levin A, Tonelli M, Bonventre J, et al. Global kidney health 2017 and beyond: a roadmap for closing gaps in care, research, and policy. Lancet. 2017;390(10105):1888–1917. doi:10.1016/S0140-6736(17)30788-228434650
  • Johnson RJ, Sánchez-Lozada LG. Mesoamerican nephropathy—new clues to the cause. Nat Rev Nephrol. 2013;9(10):560–561. doi:10.1038/nrneph.2013.17423999393
  • Roncal-Jimenez C, Lanaspa MA, Jensen T, Sanchez-Lozada LG, Johnson RJ. Mechanisms by which dehydration may lead to chronic kidney disease. Ann Nutr Metab. 2015;66(Suppl. 3):10–13. doi:10.1159/000381239
  • Jimenez CR, Ishimoto T, Lanaspa MA, et al. Dehydration-induced renal Injury: a fructokinase mediated disease? Kidney Int. 2013.
  • García-Trabanino R, Jarquín E, Wesseling C, et al. Heat stress, dehydration, and kidney function in sugarcane cutters in El Salvador–a cross-shift study of workers at risk of Mesoamerican nephropathy. Environ Res. 2015;1(142):746–755. doi:10.1016/j.envres.2015.07.007
  • Rojas-Valverde D, Olcina GJ, Gutierrez Vargas R, Crowe J. Heat strain, external workload and chronic kidney disease in tropical settings: are endurance athletes exposed? Front Physiol. 2019;10:1403. doi:10.3389/fphys.2019.0140331824329
  • Petejova N, Martinek A. Acute kidney injury due to rhabdomyolysis and renal replacement therapy: a critical review. Crit Care. 2014;18(3):224. doi:10.1186/cc1389725043142
  • Roncal-Jimenez C, García-Trabanino R, Barregard L, et al. Heat stress nephropathy from exercise-induced uric acid crystalluria: a perspective on Mesoamerican nephropathy. Am J Kidney Dis. 2016;67(1):20–30. doi:10.1053/j.ajkd.2015.08.02126455995
  • Madero M, García-Arroyo FE, Sánchez-Lozada LG. Pathophysiologic insight into MesoAmerican nephropathy. Curr Opin Nephrol Hypertens. 2017;26(4):296–302. doi:10.1097/MNH.000000000000033128426518
  • Selvarajah M, Weeratunga P, Sivayoganthan S, Rathnatunga N, Rajapakse S. Clinico pathological correlates of chronic kidney disease of unknown etiology in Sri Lanka. Indian J Nephrol. 2016;26(5):357. doi:10.4103/0971-4065.16728027795631
  • Vos T, Abajobir AA, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1211–1259.28919117
  • Seguro AC, Andrade L. Pathophysiology of leptospirosis. Shock. 2013;1(39):17–23. doi:10.1097/SHK.0b013e31828fae49
  • Yang CW. Leptospirosis renal disease: emerging culprit of chronic kidney disease unknown etiology. Nephron. 2018;138(2):129–136. doi:10.1159/00048069128926845
  • Gamage CD, Sarathkumara YD. Chronic kidney disease of uncertain etiology in Sri Lanka: are leptospirosis and hantaviral infection likely causes? Med Hypotheses. 2016;1(91):16–19. doi:10.1016/j.mehy.2016.04.009
  • Daher FE. Leptospirosis-associated acute kidney injury. J Bras Nefrol. 2010;32(4):400–407.21541455
  • Yang HY, Hung CC, Liu SH, et al. Overlooked risk for chronic kidney disease after leptospiral infection: a population-based survey and epidemiological cohort evidence. PLoS Negl Trop Dis. 2015;9(10):e0004105. doi:10.1371/journal.pntd.000410526452161
  • Wesseling C, Crowe J, Hogstedt C, Jakobsson K, Lucas R, Wegman D. Mesoamerican nephropathy: report from the first international research workshop on MeN. Heredia: SALTRA, IRET-UNA; 2013 Available from: http://www.regionalnephropathy.org/wp-content/uploads/2013/04/Techn.
  • González-Quiroz M, Pearce N, Caplin B, Nitsch D. What do epidemiological studies tell us about chronic kidney disease of undetermined cause in Meso-America? A systematic review and meta-analysis. Clin Kidney J. 2018;11(4):496–506. doi:10.1093/ckj/sfx13630094014
  • Chandrajith R, Nanayakkara S, Itai K, et al. Chronic kidney diseases of uncertain etiology (CKDue) in Sri Lanka: geographic distribution and environmental implications. Environ Geochem Health. 2011;33(3):267–278. doi:10.1007/s10653-010-9339-120853020
  • Nanayakkara S, Senevirathna ST, Parahitiyawa NB, et al. Whole-exome sequencing reveals genetic variants associated with chronic kidney disease characterized by tubulointerstitial damages in North Central Region, Sri Lanka. Environ Health Prev Med. 2015;20(5):354–359. doi:10.1007/s12199-015-0475-126108971
  • Siddarth M, Datta SK, Ahmed RS, Banerjee BD, Kalra OP, Tripathi AK. Association of CYP1A1 gene polymorphism with chronic kidney disease: a case control study. Environ Toxicol Pharmacol. 2013;36(1):164–170. doi:10.1016/j.etap.2013.03.00823619522
  • Brooks CJ, Gortmaker SL, Long MW, Cradock AL, Kenney EL. Racial/ethnic and socioeconomic disparities in hydration status among US adults and the role of tap water and other beverage intake. Am J Public Health. 2017;107(9):1387–1394. doi:10.2105/AJPH.2017.30392328727528
  • Bodin T, García-Trabanino R, Weiss I, et al. Intervention to reduce heat stress and improve efficiency among sugarcane workers in El Salvador: Phase 1. Occup Environ Med. 2016;73(6):409–416.27073211
  • Balasooriya S, Munasinghe H, Herath AT, et al. Possible links between groundwater geochemistry and chronic kidney disease of unknown etiology (CKDu): an investigation from the Ginnoruwa region in Sri Lanka. Expos Health. 2019;17:1–2.
  • Nanayakkara S, Senevirathna ST, Harada KH, et al. Systematic evaluation of exposure to trace elements and minerals in patients with chronic kidney disease of uncertain etiology (CKDu) in Sri Lanka. J Trace Elem Med Biol. 2019;1(54):206–213. doi:10.1016/j.jtemb.2019.04.019
  • Jayasumana C, Gunatilake S, Senanayake P. Glyphosate, hard water and nephrotoxic metals: are they the culprits behind the epidemic of chronic kidney disease of unknown etiology in Sri Lanka? Int J Environ Res Public Health. 2014;11(2):2125–2147. doi:10.3390/ijerph11020212524562182
  • Wanigasuriya KP, Peiris-John RJ, Wickremasinghe R. Chronic kidney disease of unknown aetiology in Sri Lanka: is cadmium a likely cause? BMC Nephrol. 2011;12(1):32. doi:10.1186/1471-2369-12-3221726464
  • Thammitiyagodage MG, Gunatillaka MM, Ekanayaka N, et al. Ingestion of dug well water from an area with high prevalence of chronic kidney disease of unknown etiology (CKDu) and development of kidney and liver lesions in rats. Ceylon Med J. 2017;62(1):20. doi:10.4038/cmj.v62i1.842828390327
  • Chandrajith R, Dissanayake CB, Ariyarathna T, Herath HM, Padmasiri JP. Dose-dependent Na and Ca in fluoride-rich drinking water—another major cause of chronic renal failure in tropical arid regions. Sci Total Environ. 2011;409(4):671–675. doi:10.1016/j.scitotenv.2010.10.04621109289
  • International expert consultation on chronic kidney disease of unknown etiology [Internet]. World Health Organization, Country Office for Sri Lanka; 2016 [cited 1120, 2020]. Available from: https://apps.who.int/iris/handle/10665/255137.
  • Perera T, Ranasinghe S, Alles N, Waduge R. Experimental rat model for acute tubular injury induced by high water hardness and high water fluoride: efficacy of primary preventive intervention by distilled water administration. BMC Nephrol. 2020;21(1):1–6. doi:10.1186/s12882-020-01763-3
  • Khandare AL, Reddy YS, Balakrishna N, Rao GS, Gangadhar T, Arlappa N. Role of drinking water with high silica and strontium in chronic kidney disease: an exploratory community-based study in an Indian Village. Indian J Community Health. 2015;27(1):95–102.
  • Raines N, González M, Wyatt C, et al. Risk factors for reduced glomerular filtration rate in a Nicaraguan community affected by Mesoamerican nephropathy. MEDICC Rev. 2014;16:16–22.
  • McClean M, Amador JJ, Laws R, et al. Biological Sampling Report: Investigating Biomarkers of Kidney Injury and Chronic Kidney Disease Among Workers in Western Nicaragua. Boston: University School of Public Health: Compliance Advisor Ombudman; 2012.
  • Baran MJ, Cibiński M. Glyphosate-based phospho-organic herbicides–an outline of action, metabolism and the selected effects on humans and other organisms. Arch Physiother Glob Res. 2014;18(1):35–45. doi:10.15442/apgr.19.2.10
  • Jayasumana C, Fonseka S, Fernando A, et al. Phosphate fertilizer is a main source of arsenic in areas affected with chronic kidney disease of unknown etiology in Sri Lanka. SpringerPlus. 2015;4(1):90. doi:10.1186/s40064-015-0868-z25763302
  • Zheng L, Kuo CC, Fadrowski J, Agnew J, Weaver VM, Navas-Acien A. Arsenic and chronic kidney disease: a systematic review. Curr Environ Health Rep. 2014;1(3):192–207. doi:10.1007/s40572-014-0024-x25221743
  • Bánfalvi G. Cellular Effects of Heavy Metals. New York: Springer; 2011.
  • Laws RL, Brooks DR, Amador JJ, et al. Biomarkers of kidney injury among Nicaraguan sugarcane workers. Am J Kidney Dis. 2016;67(2):209–217. doi:10.1053/j.ajkd.2015.08.02226454687
  • Sanoff SL, Callejas L, Alonso CD, et al. Positive association of renal insufficiency with agriculture employment and unregulated alcohol consumption in Nicaragua. Ren Fail. 2010;32(7):766–777. doi:10.3109/0886022X.2010.49433320662688
  • Lebov JF, Engel LS, Richardson D, Hogan SL, Hoppin JA, Sandler DP. Pesticide use and risk of end-stage renal disease among licensed pesticide applicators in the agricultural health study. Occup Environ Med. 2016;73(1):3–12. doi:10.1136/oemed-2014-10261526177651
  • Siriwardhana EA, Perera PA, Sivakanesan R, Abeysekara T, Nugegoda DB, Jayaweera JA. Dehydration and malaria augment the risk of developing chronic kidney disease in Sri Lanka. Indian J Nephrol. 2015;25(3):146. doi:10.4103/0971-4065.14071226060363
  • Murray KO, Fischer RSB, Chavarria D, Christiane Duttmann MN, Garcia RG, Peter J. Mesoamerican Nephropathy: A Neglected Tropical Disease with an Infectious Etiology? 2015:671–675.
  • Gamage CD, Yoshimatsu K, Sarathkumara YD, Kulendiran T, Nanayakkara N, Arikawa J. Serological evidence of hantavirus infection in Girandurukotte, an area endemic for chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka. Int J Infect Dis. 2017;1(57):77–78. doi:10.1016/j.ijid.2017.02.004
  • Peraza S, Wesseling C, Aragon A, et al. Decreased kidney function among agricultural workers in El Salvador. Am J Kidney Dis. 2012;59(4):531–540. doi:10.1053/j.ajkd.2011.11.03922300650
  • Wijkström J, Leiva R, Elinder CG, et al. Clinical and pathological characterization of Mesoamerican nephropathy: a new kidney disease in Central America. Am J Kidney Dis. 2013;62(5):908–918. doi:10.1053/j.ajkd.2013.05.01923850447
  • Nanayakkara S, Senevirathna ST, Karunaratne U, et al. Evidence of tubular damage in the very early stage of chronic kidney disease of uncertain etiology in the north central province of Sri Lanka: a cross-sectional study. Environ Health Prev Med. 2012;17(2):109–117. doi:10.1007/s12199-011-0224-z21710150
  • Brooks D, McClean M. Boston University Investigation of Chronic Kidney Disease in Western Nicaragua, 2009–2012. Boston, MA: Boston University School of Public Health; 2012.
  • Wijkström J, Jayasumana C, Dassanayake R, et al. Morphological and clinical findings in Sri Lankan patients with chronic kidney disease of unknown cause (CKDu): similarities and differences with Mesoamerican nephropathy. PLoS One. 2018;13(3):e0193056. doi:10.1371/journal.pone.019305629513702
  • López-Marín L, Chávez Y, García XA, et al. Histopathology of chronic kidney disease of unknown etiology in Salvadoran agricultural communities. MEDICC Rev. 2014;16:49–54.24878649
  • Elinder CG, Wernerson A, Wijkstrom J. Mesoamerican nephropathy (MeN). A “new” chronic kidney disease related to occupational heat exposure with repeated deprivation of salts and water. Int J Nephrol Kidney Fail. 2015;1(2):1–9.
  • Watts N, Adger WN, Ayeb-Karlsson S, et al. The lancet countdown: tracking progress on health and climate change. Lancet. 2017;389(10074):1151–1164. doi:10.1016/S0140-6736(16)32124-927856085
  • Wegman D, Crowe J, Hogstedt C, Jakobsson K, Wesseling C. Mesoamerican Nephropathy: Report from the Second International Research Workshop on MeN. 2016.
  • Roncal-Jimenez CA, Sato Y, Milagres T, et al. Experimental heat stress nephropathy and liver injury are improved by allopurinol. Am J Physiol Renal Physiol. 2018;315(3):F726–33. doi:10.1152/ajprenal.00543.201729667911
  • Rajapakse S, Shivanthan MC, Selvarajah M. Chronic kidney disease of unknown etiology in Sri Lanka. Int J Occup Environ Health. 2016;22(3):259–264. doi:10.1080/10773525.2016.120309727399161
  • Goicoechea M, de Vinuesa SG, Verdalles U, et al. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Clin J Am Soc Nephrol. 2010;5(8):1388–1393. doi:10.2215/CJN.0158021020538833
  • Johnson RJ, Wesseling C, Newman LS. Chronic kidney disease of unknown cause in agricultural communities. N Engl J Med. 2019;380(19):1843–1852. doi:10.1056/NEJMra181386931067373
  • Polo VS, Garcia-Trabanino R, Rodriguez G, Madero M. Mesoamerican nephropathy (MeN): what we know so far. Int J Nephrol Renovasc Dis. 2020;13:261.33116757
  • Di Iorio BR, Bellasi A, Raphael KL, et al. Treatment of metabolic acidosis with sodium bicarbonate delays progression of chronic kidney disease: the UBI Study. J Nephrol. 2019;32(6):989–1001. doi:10.1007/s40620-019-00656-531598912
  • Sánchez-Lozada LG, García-Arroyo FE, Gonzaga G, et al. Kidney injury from recurrent heat stress and rhabdomyolysis: protective role of allopurinol and sodium bicarbonate. Am J Nephrol. 2018;48(5):339–348. doi:10.1159/00049466330391956
  • Butler-Dawson J, Krisher L, Asensio C, et al. Risk factors for declines in kidney function in sugarcane workers in Guatemala. J Occup Environ Med. 2018;60(6):548. doi:10.1097/JOM.000000000000128429370016
  • Aguilar-Ramirez D, Raña-Custodio A, Villa A, et al. Decreased kidney function and agricultural work: a cross-sectional study in middle-aged adults from Tierra Blanca, Mexico. Nephrol Dial Transplant. 2020. doi:10.1093/ndt/gfaa041