Dataset Information

A Newly Recognized Endemic Region of CKD of Undetermined Etiology (CKDu) in South India-"Tondaimandalam Nephropathy".

ABSTRACT: Introduction:Chronic kidney disease (CKD) is being increasingly recognized as a public health problem in India. The entity of CKD of undetermined etiology (CKDu) is increasingly being reported globally. Here we describe the burden of CKDu in a heretofore undescribed population in South India. Methods:We prospectively enrolled all patients with CKD referred to the nephrology department in an observational registry. We analyzed their sociodemographic and clinical features over 4 years. The diagnosis of CKD and its etiology was determined using predefined criteria. Geolocalization of CKD patients was performed. Subsequently, CKD screening was conducted in a village located in an area of CKDu clustering. Results:A total of 2424 patients were analyzed; the median age was 52 years and 75.3% were male. Seventy-five percent had advanced CKD. CKDu was the most common (51.7%) etiologic category. This is the highest proportion of CKDu reported among all published CKD studies to date from India. The clinical and demographic profile of this patient population match that of CKDu patients reported from Sri Lanka and Central America, where CKDu is endemic. A clustering of cases of CKDu was noted in specific districts using a geographic information system software. Screening of 447 people in an outreach program at a village located in an area identified to have clustering of CKDu showed a CKD prevalence of 19%. Conclusion:We report a previously unrecognized endemic area of CKDu among the underprivileged population engaged in agricultural labor in coastal southeastern India in the states of Tamil Nadu and Puducherry (Tondaimandalam) in India.

SUBMITTER: Parameswaran S

PROVIDER: S-EPMC7609951 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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A Newly Recognized Endemic Region of CKD of Undetermined Etiology (CKDu) in South India-"Tondaimandalam Nephropathy".

Parameswaran Sreejith S Rinu P Krishnankutty PK Kar Sitanshu Sekhar SS Harichandrakumar Kotteyen Thazhath KT James Thottyplackel Devassiya TD Priyamvada Puthenpurackal Sivan Pillai PSP Haridasan Satish S Mohan Sumit S Radhakrishnan Jai J

Kidney international reports 20200915 11

<h4>Introduction</h4>Chronic kidney disease (CKD) is being increasingly recognized as a public health problem in India. The entity of CKD of undetermined etiology (CKDu) is increasingly being reported globally. Here we describe the burden of CKDu in a heretofore undescribed population in South India.<h4>Methods</h4>We prospectively enrolled all patients with CKD referred to the nephrology department in an observational registry. We analyzed their sociodemographic and clinical features over 4 yea ...[more]

PMID: 33163727

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Project description:BackgroundIn Sri Lanka, there exists chronic kidney disease of both known (CKD) and unknown etiologies (CKDu). Identification of novel biomarkers that are customized to the specific causative factors would lead to early diagnosis and clearer prognosis of the diseases. This study aimed to find genetic biomarkers in blood to distinguish and identify CKDu from CKD as well as healthy populations from CKDu endemic and non-endemic areas of Sri Lanka.MethodsThe expression patterns of a selected panel of 12 potential genetic biomarkers were analyzed in blood using RT-qPCR. Fold changes of gene expressions in early and late stages of CKD and CKDu patients, and an apparently healthy population of a CKDu endemic area, Girandurukotte (GH) were calculated relative to apparently healthy volunteers from a CKDu non-endemic area, Kandy (KH) of Sri Lanka, using the comparative CT method.ResultsSignificant differences were observed between KH and early stage CKDu for both the insulin-like growth factor binding protein 1 (IGFBP1; p?=?0.012) and kidney injury molecule-1 (KIM1; p?=?0.003) genes, and KH and late stage CKD and CKDu for the glutathione-S-transferase mu 1 (GSTM1; p?<?0.05) gene. IGFBP1 and KIM1 genes showed significant difference between the early and late stage CKDu (p?<?0.01). The glutamate cysteine ligase catalytic subunit (GCLC) gene had significantly different expression between KH and all the other study groups (p?<?0.01). The GH group was significantly different from the KH group for the oxidative stress related genes, G6PD, GCLC and GSTM1 (p?<?0.01), and also the KIM1 gene (p?=?0.003). IGFBP1, insulin-like growth factor binding protein 3 (IGFBP3), fibronectin 1 (FN1) and KIM1 showed significant correlations with serum creatinine, and IGFBP1, KIM1 and kallikrein 1 (KLK1) with eGFR (p?<?0.05).ConclusionA panel consisting of IGFBP1, KIM1, GCLC and GSTM1 genes could be used in combination for early screening of CKDu, whereas these genes in addition with FN1, IGFBP3 and KLK1 could be used to monitor progression of CKDu. The regulation of these genes has to be studied on larger populations to validate their efficiency for further clinical use.

Dataset Information

A Newly Recognized Endemic Region of CKD of Undetermined Etiology (CKDu) in South India-"Tondaimandalam Nephropathy".

Publications

A Newly Recognized Endemic Region of CKD of Undetermined Etiology (CKDu) in South India-"Tondaimandalam Nephropathy".

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