Clinicopathological Study of Chronic Kidney Disease of Unknown Etiology in Odisha

Chronic kidney disease (CKD) is a global burden and commonly characterized by traditional risk factors like diabetes, hypertension, glomerulonephritis, but it is emerging as a serious health problem specially in the state of Odisha, India. This is as per a new cross-sectional study conducted on 124 consecutive patients with Chronic kidney disease.

A new form of severe Chronic kidney disease affecting adults, being named as Chronic kidney disease of unknown origin (CKDu), and it is fatal due to late recognition and rapid disease progression.

A questionnaire was answered and after the necessary history, clinical evaluation, and blood and urine analyses, a kidney biopsy was undertaken. Kidney biopsy was feasible in 51 patients as the rest 61 patients had shrunken kidneys. Among the 51 patients, 23 had Chronic kidney disease of unknown origin, 25 had chronic glomerulonephritis and three biopsies were inconclusive.

Results showed that a family history of Chronic kidney disease was seen in 82.6% of Chronic kidney disease of unknown origin cases. Hyponatremia and hypokalemia were predominant biochemical abnormalities. There was an increased risk of developing Chronic kidney disease of unknown origin in persons with a family history of Chronic kidney disease persons exposed to smoke from burning coal, charcoal or biomass fuels and patients with low socio-economic status. Interstitial fibrosis (IF), interstitial inflammation with mononuclear infiltration, tubular atrophy (TA), and global glomerulosclerosis (GS) were pertinent histopathological findings in this study.

The researchers hence concluded that there is no strong evidence for a single cause for chronic kidney disease of unknown origin, and multiple environmental, occupational and social factors are probably involved and so the identification of such etiologies of chronic kidney disease of unknown origin, across high-risk populations may help elucidate the importance of risk factors.

Reference: Parida S, Das S, Kar A, et al. Clinicopathological Study of Chronic Kidney Disease of Unknown Etiology in Odisha. J Assoc Physicians India 2022;70(10):39–46.