Chronic Interstitial Nephritis in Agricultural Communities

2018 ◽  
Author(s):  
Channa Jayasumana ◽  
Carlos Orantes ◽  
Marc E. De Broe
Keyword(s):  
Sri Lanka ◽  
Central America ◽  
Interstitial Nephritis ◽  
Agricultural Communities ◽  
The North ◽  
History Of ◽  
North Central Province ◽  
End Stage ◽  
Chronic Interstitial Nephritis ◽  
The Tropics

Chronic Interstitial Nephritis in Agricultural Communities (CINAC) has been increasingly recognized since the early 1990s. It has been called epidemic chronic kidney disease unknown cause (CKDu) in Sri Lanka, and meso-American nephropathy in Central America. CINAC occurs regionally in the Tropics, predominantly in rural/agricultural zones. It is increasingly recognized, but also believed to be increasing in incidence. Men are affected up to three times more often than women. Its incidence increases with age, and a number of other epidemiological factors impact on it. In some areas, such as the North Central Province of Sri Lanka and regions of Central America, it drives extreme rates of CKD and end-stage renal failure. Clinically, it has the non-specific characteristics of other slowly-evolving chronic interstitial nephritis (Chapter 86). Perhaps distinctive is an inconsistent history of episodes of dysuria, sometimes loin pain, in earlier disease. Its aetiology remains unsolved. Maps of incidence commonly show a mosaic pattern, suggesting that exposure to local factors are implicated. It has been associated with working outdoors in high temperatures, but this seems inadequate as the sole explanation. Exposure to nephrotoxins, natural or possibly as agrochemicals, seems likely.

Chronic kidney disease mortality trends in selected Central America countries, 1997–2013: clues to an epidemic of chronic interstitial nephritis of agricultural communities

2018 ◽  
Vol 72 (4) ◽  
pp. 280-286 ◽  
Author(s):  
Pedro Ordunez ◽  
F Javier Nieto ◽  
Ramon Martinez ◽  
Patricia Soliz ◽  
Gloria P Giraldo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Heat Stress ◽  
Kidney Disease ◽  
Central America ◽  
Interstitial Nephritis ◽  
Statistical Modelling ◽  
Mortality Trends ◽  
Mortality Pattern ◽  
Agricultural Communities ◽  
Chronic Interstitial Nephritis

BackgroundIn Central America, chronic interstitial nephritis of agricultural communities (CINAC) has reached epidemic proportions. Clusters of cases have been described in several farming communities. Its aetiology remains uncertain and a controversy exists on its key triggers, among them the heat stress–dehydration mechanism and the toxic exposure to agrochemicals.MethodsThis study analysed the mortality pattern and trend of chronic kidney disease code N18 (CKD-N18) according to the International Statistical Classification of Diseases and Related Health Problems-10th Revision, the proxy and the underlying cause of death, in four selected Central American countries from 1997 to 2013. In addition, we used exponential regression to retrospectively model the likely onset and prior trajectory of the epidemic.ResultsBetween 1997 and 2013, CKD-N18 mortality accounting 47 885 deaths (31% were female), 19 533 of which occurred below 60 years of age (26% female). The excess of mortality starts as early as 10–14 years of age for both boys and girls. El Salvador and Nicaragua, with mortality rates between 9-fold and 12-fold higher than reference countries, were the most affected. Statistical modelling suggests that the epidemic commenced around the mid-1970s, coinciding with important changes in modes of agricultural production.ConclusionsThis study provides the most comprehensive mortality analysis of this epidemic published to date and confirms an excess of CKD-N18 mortality and its relation with the epidemic of CINAC. The overall trends and the mortality pattern among women, children and adolescents suggest that the heat stress–dehydration hypothesis cannot fully explain this epidemic and that other environmental factors, more likely agricultural practices and agrochemicals, may be causally involved.

Karyomegalic interstitial nephritis: diagnosed only when suspected

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Monica Sivakumar ◽  
Balan Louis Gaspar ◽  
Balakrishnan Narasimhan
Keyword(s):  
Renal Biopsy ◽  
Interstitial Nephritis ◽  
Wide Range ◽  
The Status ◽  
History Of ◽  
Prognostic Implications ◽  
Stage Renal Disease ◽  
End Stage ◽  
Chronic Interstitial Nephritis ◽  
Kidney Functions

Abstract Background Karyomegalic interstitial nephritis (KIN) is an uncommon cause of chronic interstitial nephritis that eventually progresses to end-stage renal disease. Overall less than 50 cases have been reported in the literature. Case presentation We describe an asymptomatic 25-year-old gentleman with a family history of chronic interstitial nephritis who came to check the status of his kidney functions. On evaluation, he was found to have chronic interstitial nephritis which could not be attributed to a specific etiology. Renal biopsy confirmed the diagnosis of KIN. Conclusion KIN remains underdiagnosed. It is important to recognize this entity because of the familial nature, a wide range of differential diagnoses, and prognostic implications. A high index of clinical suspicion is necessary to perform renal biopsy which remains the gold standard for the diagnosis of KIN.

Spontaneous Glomerulonephritis in Dogs: II. Correlation of Glomerulonephritis with Age, Chronic Interstitial Nephritis and Extrarenal Lesions

1977 ◽  
Vol 14 (2) ◽  
pp. 121-127 ◽  
Author(s):  
R. Müller-Peddinghaus ◽  
G. Trautwein
Keyword(s):  
Interstitial Nephritis ◽  
Membranoproliferative Glomerulonephritis ◽  
Age Groups ◽  
Renal Amyloidosis ◽  
Morphologic Study ◽  
Different Types ◽  
End Stage ◽  
Chronic Interstitial Nephritis ◽  
Slight Damage ◽  
Severe Fibrosis

A morphologic study of 103 dogs, including two with renal amyloidosis, showed that different types of diffuse glomerulonephritis are correlated with different age groups. Membranous and membranoproliferative glomerulonephritis were more common in middle-aged and older animals, whereas mesangial lesions were found predominantly in younger dogs and considered to be early glomerular changes. Glomerulonephritis largely occurred independently of interstitial nephritis. The incidence of interstitial lesions was 71%. Chronic interstitial nephritis was rare in dogs under 1 year old. Glomerulonephritis did not seem to induce interstitial nephritis. Glomerulonephritis occurred not only in kidneys with severe interstitial damage, but also in those with slight damage. This indicated that glomerulonephritis occurred independently of interstitial nephritis. In end-stage kidneys with severe fibrosis, mesangial changes seemed to predominate.

scholarly journals The incidence, prevalence and trends of Chronic Kidney Disease and Chronic Kidney Disease of uncertain aetiology (CKDu) in the North Central Province of Sri Lanka: an analysis of 30,566 patients

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Asanga Venura Ranasinghe ◽  
Gardiye Weligamage Gamini Priyantha Kumara ◽  
Ranamuka Henayage Karunarathna ◽  
Ambepitiyawaduge Pubudu De Silva ◽  
Korale Gedara Dilini Sachintani ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Central Province ◽  
North Central ◽  
The North ◽  
North Central Province ◽  
Incidence Prevalence

scholarly journals A checklist of the vascular plants of the lowland savannas of Belize, Central America

Phytotaxa ◽  
2013 ◽  
Vol 101 (1) ◽  
pp. 1 ◽  
Author(s):  
ZOË A. GOODWIN ◽  
GERMAN N. LOPEZ ◽  
NEIL STUART ◽  
SAMUEL G.M. BRIDGEWATER ◽  
ELSPETH M. HASTON ◽  
...  
Keyword(s):  
Central America ◽  
Vascular Plants ◽  
New Records ◽  
Red List ◽  
The Third ◽  
World Conservation ◽  
The North ◽  
The World ◽  
History Of ◽  
Herbarium Collections

 Lowland savannas, covering an area of 2,342 km2, form the third largest ecosystem in Belize yet are unevenly and therefore poorly represented in the country’s protected area system. Based on more than 5,700 herbarium collections, a checklist of 957 species of vascular plants is presented for this ecosystem representing ca. 28% of the Belizean flora, of which 54 species are new records for the country. Of the 41 species of plants known to be endemic to Belize, 18 have been recorded within the lowland savanna, and nine species are listed in The World Conservation Union (IUCN) 2010 Red List of Threatened Species. Of the total savanna ecosystem flora, 339 species are characteristic of the open savanna, whilst 309 and 114 species are more frequent in forest and wetland areas respectively. Most species (505, 53% of the lowland savanna flora) are herbaceous. Although the lowland savanna has been relatively well collected, there are geographical biases in botanical sampling which have focused historically on the savannas in the centre and the north of the country. A brief review of the collecting history of the lowland savanna is provided, and recommendations are given on how future collecting efforts may best be focused. The lowland savanna is shown to be a significant regional centre of plant diversity.

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