scholarly journals Chronic Kidney Disease of Uncertain Etiology in Sri Lanka: Curing between Medicine and Traditional Culture

2022 ◽  
Vol 11 (1) ◽  
pp. 20
Author(s):  
Chandani Liyanage

Chronic Kidney Disease of unknown origin (CKDu) has appeared across Sri Lanka’s North Central Province (NCP) since the 1990s as an epidemic, unexplained by conventional associated risk factors. During the past few decades, a large number of studies attempted to determine the unknown etiology of CKDu. Despite these investigations, no concrete conclusions were developed, though a number of contradictory hypotheses emerged. The present ethnographic study was carried out in two endemic areas, labelled as “CKDu hotspots”, and illuminates how curing takes place between biomedicine and traditional cultural practices. Our ethnographic study thoroughly scrutinized three decades of lived experience, lay-perceptions and local discourses on CKDu. We used a qualitative study design with a transcendental phenomenological approach and employed a mixture of ethnographic methods. Data collection techniques included participant observation, in-depth interviews, focus group discussions and key informant interviews. Data was analysed by using an interpretive thematic analysis model. Findings revealed that lay people have constructed a popular discourse on CKDu, and we explored their views on the origin, etiology and prevalence of CKDu in their locality over the past few decades. Patients’ narratives revealed that there were currently a number of gaps in service delivery. These were mainly due to distant relationships between healthcare providers and CKDu patients. Lay people in affected communities were marginalized throughout the investigation process to determine the unknown etiology, their involvement marginalized to merely acting as objects for scientific instigation. The affected communities strongly believed that CKDu was a recent phenomenon resulting from the mismanagement of the natural environment due to social and lifestyle changes. These findings highlight local dynamics of healthcare seeking behaviours which demand complementary medicine system, particularly given the number of limitations in the biomedical system. Empirical evidence generated from this study suggests a conceptual shift to an ethno-medical model to address CKDu. Improving cultural competency and communication skills among healthcare providers in public health are crucial in order to apply a “bio-psychosocial perspective” in healthcare delivery system and bridging the gap between hospital and the community.

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 ◽  
...  

2017 ◽  
Vol 41 (4) ◽  
pp. 216-220 ◽  
Author(s):  
Sumeet Gupta ◽  
Udayan Khastgir

SummaryLithium is an established treatment for bipolar disorder and an augmenting agent for treatment-resistant depression. Despite awareness of renal adverse effects, including chronic kidney disease, for the past five decades, there has been a lack of research evidence. This has led to debates around the existence and magnitude of the risk. This article discusses the current evidence base regarding the link between lithium and chronic kidney disease, monitoring of renal functions and its clinical implications.


2019 ◽  
Vol 3 (1) ◽  
pp. 31-38 ◽  
Author(s):  
Pooja Amarapurkar ◽  
Salim Bou-Slaiman ◽  
Bianca Madrid ◽  
Marco Ladino

Over the past decade, the relationships between various kidney disease and cancer have been established, but not fully elucidated. Development of acute kidney injury or chronic kidney disease as a side effect of cancer treatment is not uncommon. However, renal paraneoplastic diseases are rather unique and less known examples of the association between kidney disease and cancer. These conditions are of importance to the nephrologist as they may be the initial presentation of an underlying malignancy and may not respond to the usual therapies used for their non-paraneoplastic variants. This article will discuss the pathogenesis and challenges in management of paraneoplastic glomerular diseases.


Author(s):  
Jörg Rapp ◽  
Engelbert Niehaus ◽  
Alexandre Ribó ◽  
Roberto Mejía ◽  
Edgar Quinteros ◽  
...  

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