A critical review published in Environmental Science: Advances sheds light on the growing global epidemic of chronic kidney disease of unknown etiology (CKDu), a severe form of kidney disease affecting individuals without traditional risk factors such as diabetes or hypertension. The review, led by researchers from the University of Iowa and Michigan State University, explores the potential occupational and environmental causes of CKDu, particularly among agricultural workers in low- and middle-income countries.

Key insights from the review include:

• CKDu is rising in rural agricultural communities, especially in regions like Central America and South Asia, where young male farmers are disproportionately affected.
• Heat stress, dehydration, and exposure to agrochemicals such as heavy metals and pesticides are among the leading hypothesized causes.
• The disease has been referred to by various names—including Mesoamerican nephropathy and CINAC—complicating global recognition and response efforts.
• Lack of standardized definitions and data sharing has hindered understanding of CKDu’s global burden and slowed progress toward prevention and treatment.

The authors call for a unified global approach to CKDu research, emphasizing the need for improved surveillance, consistent diagnostic criteria, and targeted studies on environmental and occupational exposures.

“This review brings together decades of research to highlight the urgent need for action on CKDu,” said co-author Dr. Darrin Thompson. “We must better understand how environmental and workplace conditions contribute to this disease to protect vulnerable populations.”

The full article is available open access at Environmental Science: Advances.