Published: 2022-05-24

A study on causes of chronic kidney disease in patients without diabetes mellitus and systemic hypertension in a tertiary care hospital

Praveen J., Tumbanatham A., Sivashankar M.


Background: Chronic kidney disease is an increasing health problem worldwide Thus apart from the well-established risk factors for CKD such as diabetes and systemic hypertension, the possibility that environmental, demographic, and various other risk factors an influence in developing chronic kidney disease has been assessed in several studies. Hence, the present study aimed to study the clinical and laboratory profile of chronic kidney disease in non-diabetic and non-hypertensive patients

Methods: The study was enrolled 100 patients diagnosed with chronic kidney disease without diabetes and systemic hypertension in the department of general medicine and department of nephrology in a tertiary care hospital, Pondicherry for 1 year. The baseline data such as socioeconomic status, history of self-consumption of natural medicine and NSAIDs, their occupations, location of their living place, and routine laboratory parameters were collected and analysed.

Results: The socioeconomic status of the present study revealed that upper lower class was the predominant status and the majority of the patients were housewives and farmers. 38% of the patients were exposed to insecticides that were associated with CKD (p=0.0327). 40% of the study population was victims of NSAID consumers (p=0.0236). 42% was consumed natural medication on their own for their illness 46 without any consultation (p=0.0324). The patients came from Cuddalore predominantly (22%).

Conclusions: Insecticide exposure, self-consumption of NSAIDs, and natural medicine are the main causes that progress to CKD in the present study.



CKD, NSAIDs, Insecticide, Natural medicine, Risk factors

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Xie Y, Bowe B, Mokdad AH. Analysis of the global burden of disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney Int. 2018;94:567-81.

Vos T, Abajobir AA, Abbafati C. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017;390:1211-59.

Ene-Iordache B, Perico N, Bikbov B. Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study. Lancet Glob Health. 2016;4:e307-19.

Couser WG, Remuzzi G, Mendis S, Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases. Kidney Int. 2011;80:1258-70.

Gifford FJ, Gifford RM, Eddleston M, Shaun N. Endemic nephropathy around the world. Kidney Int Rep. 2017;2:282-92.

Jayasumana C, Paranagama P, Agampodi S, Wijewardane C, Gunatilake S, Siribaddana S. Drinking well water and occupational exposure to herbicides is associated with chronic kidney disease, in Padavi-Sripura, Sri Lanka. Environ Health. 2015;14:6.

Redmon JH, Elledge MF, Womack DS, et al.: Additional perspectives on chronic kidney disease of unknown etiology (CKDu) in Sri Lanka--lessons learned from the WHO CKDu population prevalence study. BMC Nephrol. 2014;15:125.

Correa-Rotter R, Wesseling C, Johnson RJ. CKD of unknown origin in Central America: the case for a Mesoamerican nephropathy. Am J Kidney Dis. 2014;63:506-20

Orantes CM, Herrera R, Almaguer M, Brizuela EG, Herna´ndez CE, Bayarre H, et al. Chronic ~ kidney disease and associated risk factors in the Bajo Lempa region of El Salvador: Nefrolempa study, 2009. MEDICC Rev. 2011;13:14-22.

Martin-Cleary C, Ortiz A. CKD hotspots around the world: Where, why and what the lessons are. A CKJ review series. Clin Kidney J. 2014;7:519-23.

Correa-Rotter R, Wesseling C, Johnson RJ. CKD of unknown origin in Central America: The case for a Mesoamerican nephropathy. Am J Kidney Dis. 2014;63:506-20.

Rajapurkar MM, John GT, Kirpalani AL. What do we know about chronic kidney disease in India: first report of the Indian CKD registry. BMC Nephrol. 2012;13:10.

John O, Gummudi B, Jha A, Gopalakrishnan N, Kalra OP, Kaur P, et al. Chronic Kidney Disease of Unknown Etiology in India: What Do We Know and Where We Need to Go. Kidney Int Rep. 2021;6(11):2743-51.

Ghahramani N. Silica nephropathy. Int J Occup Environ Med. 2010;1:108-15.

Reddy D, Gunasekar A. Chronic kidney disease in two coastal districts of Andhra Pradesh, India: role of drinking water. Environ Geochem Health. 2013;35:439-54.

Khandare AL, Reddy YS, Balakrishna N. Role of drinking water with high silica and strontium in chronic kidney disease: an exploratory community-based study in an Indian Village. Indian J Commu Health. 2015;27:95-102.

Lal K, Sehgal M, Gupta V. Assessment of groundwater quality of CKDu affected uddanam region in Srikakulam district and across Andhra Pradesh, India. Groundwater Sustain Develop. 2020;11:100432.

Tatapudi RR, Rentala S, Gullipalli P. High prevalence of CKD of unknown etiology in Uddanam, India. Kidney Int Rep. 2018;4:380-9.

Ghosh R, Siddarth M, Singh N. Organochlorine pesticide level in patients with chronic kidney disease of unknown etiology and its association with renal function. Environ Health Prevent Med. 2017;22:1-8.

Lin S-Y, Ju S-W, Lin CL. Air pollutants and subsequent risk of chronic kidney disease and end-stage renal disease: a population-based cohort study. Environmen Pollut. 2020;261:114.

Bowe B, Xie Y, Li T. Particulate matter air pollution and the risk of incident CKD and progression to ESRD. J Am Soc Nephrol. 2018;29:218-30.

The World’s 30 Most Polluted Cities Are In India: Report India 2021. Available at: https://www.ndtv. com/indianews/22-of-the-worlds-30-most-polluted-cities-are-in-india delhi-most-polluted-capital-city-report-2392028. Accessed on 20 November 2021.

Yang CW. Leptospirosis renal disease: emerging culprit of chronic kidney disease unknown etiology. Nephron. 2018;138:129-36.

Prasad N, Prakash S, Kahn Aw, Bhadauria D, Gupta A. SUN-01 genome wide analysis study to evaluate potential genetic risks and immunological pathways associated with chronic kidney disease of unknown etiology. Kidney Int Rep. 2019;4(7):S242.

Fernando BN, Sudeshika TS, Hettiarachchi TW, Badurdeen Z, Abeysekara TD, Abeysundara HT, et al. Evaluation of biochemical profile of Chronic Kidney Disease of uncertain etiology in Sri Lanka. Plos One. 2020;15(5):e0232522.