scholarly journals A national analysis of risk for potential chronic kidney disease of unknown etiology in Ecuador

2020 ◽  
Vol 5 (2) ◽  
Author(s):  
Rachel Sippy ◽  
Martín Lotto ◽  
Abigail Bideaux ◽  
Irene Torres ◽  
Sriram Narsipur ◽  
...  

An increase of chronic kidney disease (CKD) has affected many tropical countries but with an atypical presentation. This illness, known as Chronic Kidney Disease of Unknown Etiology (CKDu), presents in younger adults without the typical comorbidities for CKD, often among those working in agricultural production. The cause of disease is unknown but temperature, heat stress, or dehydration are thought to contribute to the development of this condition. There is no information on whether anyone in Ecuador is affected by this illness. We describe CKD rates in Ecuador and hypothesize that CKD is impacted by temperature and the agricultural industry in Ecuador. Using publicly available data from the Instituto Nacional de Estadísticas y Censos from the years 2010—2015, we describe the rate of CKD among adults aged 20—45 in each province, as well as the agricultural industry across Ecuador. We combined this information with land surface temperature and used a Poisson mixed effects model to assess the relationship between mean temperature, maximum temperature and agricultural industry with CKD rates among adults aged 20—49 in each province. We found that the CKD rate is increasing in this age group over 2010—2015 (p=0.017), and in 2015, CKD rates were highest in Pastaza. Our spatial analysis found that both mean temperature and proportion of population in agriculture were positively associated with CKD rate by province in 2014 and 2015. This preliminary analysis shows that temperature and agricultural industry are associated with CKD rates among adults aged 20—49. While this association does not definitively show the presence of CKDu, it provides evidence to support further investigation of this illness in Ecuador.

Biomolecules ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 261
Author(s):  
Harindu Rajapaksha ◽  
Dinesh R. Pandithavidana ◽  
Jayangika N. Dahanayake

Chronic kidney disease of unknown etiology (CKDu) has been recognized as a global non-communicable health issue. There are many proposed risk factors for CKDu and the exact reason is yet to be discovered. Understanding the inhibition or manipulation of vital renal enzymes by pesticides can play a key role in understanding the link between CKDu and pesticides. Even though it is very important to take metabolites into account when investigating the relationship between CKDu and pesticides, there is a lack of insight regarding the effects of pesticide metabolites towards CKDu. In this study, a computational approach was used to study the effects of pesticide metabolites on CKDu. Further, interactions of selected pesticides and their metabolites with renal enzymes were studied using molecular docking and molecular dynamics simulation studies. It was evident that some pesticides and metabolites have affinity to bind at the active site or at regulatory sites of considered renal enzymes. Another important discovery was the potential of some metabolites to have higher binding interactions with considered renal enzymes compared to the parent pesticides. These findings raise the question of whether pesticide metabolites may be a main risk factor towards CKDu.


Endocrine ◽  
2021 ◽  
Author(s):  
Walter Reinhardt ◽  
Nils Mülling ◽  
Stefan Behrendt ◽  
Sven Benson ◽  
Sebastian Dolff ◽  
...  

Abstract Purpose The relationship between proteinuria and thyroid function remains controversial in patients with chronic kidney disease (CKD). We prospectively investigated the association between kidney and thyroid function in thyroid antibody-negative patients through all CKD stages. Methods We enrolled 184 nondialysis patients (mean age: 63.1 ± 16.9 years) without previous thyroid disease or thyroid-specific antibodies. Kidney function was assessed by estimating the glomerular filtration rate (eGFR) classified according KDIGO (CKD G1–5). Kidney damage was assessed by albuminuria (albumin-to-creatinine ratio, ACR) and classified as mild, moderate, or severe (ACR1: <300, ACR2: 300–3000, and ACR3: 3000 mg/g). To evaluate thyroid function, TSH, T4, fT4, T3, fT3, reverse T3 (rT3), and thyroxine-binding globulin (TBG) were measured. Results rT3 concentrations correlated negatively with albuminuria (r = −0.286, p < 0.001) and were significantly lower in patients with severe albuminuria than in those with mild or moderate albuminuria (ACR3: 0.28 vs. ACR2: 0.32 vs. ACR1: 0.36 nmol/l, p < 0.001). The severity of albuminuria revealed no impact on TSH, fT4, T3, fT3, and TBG. EGFR correlated with increasing T4, fT4, T3, fT3, and TBG (T4: r = 0.289, p < 0.01; fT4: r = 0.196, p < 0.01; T3: r = 0.408, p < 0.01; fT3: r = 0.390, p < 0.01) but not with rT3. Conclusions In thyroid antibody-negative patients presenting advanced CKD (stages 4 and 5), even severe kidney protein loss failed to influence thyroid hormone status. However, albuminuria severity correlated negatively with rT3, which was significantly lower in patients with albuminuria in the nephrotic range.


2021 ◽  
Author(s):  
Roser Torra ◽  
Mónica Furlano ◽  
Alberto Ortiz ◽  
Elisabet Ars

Abstract Inherited kidney diseases (IKDs) are among the leading causes of early-onset chronic kidney disease (CKD) and are responsible for at least 10–15% of cases of kidney replacement therapy (KRT) in adults. Pediatric nephrologists are very aware of the high prevalence of IKDs among their patients, but this is not the case for adult nephrologists. Recent publications have demonstrated that monogenic diseases account for a significant percentage of adult cases of CKD. A substantial number of these patients have received a non-specific/incorrect diagnosis or a diagnosis of CKD of unknown etiology, which precludes correct treatment, follow-up and genetic counseling. There are a number of reasons why genetic kidney diseases are difficult to diagnose in adulthood: a) adult nephrologists, in general, are not knowledgeable about IKDs, b) existence of atypical phenotypes, c) genetic testing is not universally available, d) family history is not always available or may be negative, e) lack of knowledge of various genotype–phenotype relationships, f) conflicting interpretation of the pathogenicity of many sequence variants.


2021 ◽  
pp. 111779
Author(s):  
D.N.D. Liyanage ◽  
Saranga Diyabalanage ◽  
S.P. Dunuweera ◽  
Sanath Rajapakse ◽  
R.M.G. Rajapakse ◽  
...  

2021 ◽  
Vol 46 ◽  
pp. S692
Author(s):  
H.M. Abeywickrama ◽  
Y. Koyama ◽  
S. Wimalasiri ◽  
M. Uchiyama ◽  
U. Shimizu ◽  
...  

Hypertension ◽  
2013 ◽  
Vol 62 (suppl_1) ◽  
Author(s):  
Cheng Wang ◽  
Jun Zhang ◽  
Cuicui Li ◽  
Wenyu Gong ◽  
Tanqi Lou

Background: Neural precursor cell expressed developmentally down-regulated 4-like (NEDD4L) is a candidate gene for hypertension, and carriers of an intact NEDD4L C2-domain,encoded by the NEDD4L rs4149601 (G/A) GG genotype, together with the C-allele of the NEDD4L rs2288774 (C/T) polymorphism have been found be associated with hypertension both in African Americans and whites. However, there is no data on the relationship between polymorphism of NEDD4L rs4149601 and rs2288774 and hypertension in Chinese chronic kidney disease (CKD) patients. The purpose of the current study was to investigate the relationship between the variation of NEDD4L rs4149601, rs2288774 and hypertension in CKD patients. Methods: A total of 546 Chines Hans CKD patients were enrolled in our study. The SNPs were genotyped using PCR-based techniques. All patients underwent ambulatory blood pressure monitoring, and clinical data were also collected. Multivariate logistic regression analysis was used to identify the relationship between polymorphisms and hypertension. Results: 506 patients carried GG/GA genotype and 30 carried AA genotype. Rs4149601 AA genotype carriers had significantly higher rate of hypertension (68.3% vs 46.2%, P = 0.022) than GG/GA genotype carriers by Chi-squared test. AA genotype carriers also had a higher day-time and bedtime systolic blood pressure (142±16 vs 135±23, P=0.036; 137±18 vs 127±13, P=0.022, respectively) when compared with GG/GA genotype carriers. AA genotype [OR= 3.08, 95% CI (1.06-9.80)], lowever eGFR [OR=0.98, 95% CI (0.97-0.99)], older age [OR=1.03, 95% CI (1.01-1.05)] were independently associated with hypertension in CKD patients by multivariate logistic regression. However, No difference was found in blood pressure with rs2288774 TT/TC/CC genotypes, and no difference was found in the incidence of hypertension among patients with three genotypes. Conclusions: Our results suggested 4149601AA genotype of NEDD4L may be associated with hypertension in CKD patients, and further genetic and functional studies are required to understand its role in the manifestation of hypertension in Chinese CKD patients.


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