Incidence of Chronic Kidney Disease of Unknown-etiology
(CKDu) has emerged in South Asia and sub-Saharan Africa over the last few
years. The prevalence of CKDu is approximately 10% worldwide and 16.4% in the
Indian subcontinent. This study focuses on investigating the link between
organochlorine pesticides and chronic kidney disease of unknown origin, which
is a growing health concern in agricultural communities across the world. CKDu
is not attributed to diabetes, hypertension or other known causes of CKD. It
affects younger individuals and is usually asymptomatic till advanced stages.
Organochlorine pesticides (OCPs) are one of the proposed etiologies of CKDu.
The present study was done to evaluate the serum level of certain commonly
encountered OCPs (α -HCH, β-HCH, g-HCH, total HCH, Aldrin, Dieldrin, (α-
endosulfan, β-endosulfan, p, p’-DDT, p, p’-DDE) and total pesticide load (TPL)
in patients with CKDu in comparison to patients with CKD of known etiology
(CKDk) and to assess their correlation, if any. It was a case-control,
cross-sectional study conducted in East Delhi. Subjects within the age group
18-60 years were enrolled under 3 groups: Group I: Healthy controls (n=30),
Group II: Patients with CKDu (n=30), and Group III: Patients with Chronic
Kidney Disease of Known-etiology CKDk (n=30). Detailed history, physical
examination and routine investigations were done. OCP levels were estimated in
all subjects by high-performance liquid chromatography. The association of the
estimated Glomerular filtration rate with OCP levels was obtained by
calculating the coefficient of correlation. CKDu had a predilection for the
younger age group. Females tend to have a higher concentration of most OCPs.
The median serum levels of all OCPs were found higher in patients of CKDu in
comparison to other groups. The difference was statistically significant for α
-HCH, β-HCH, total HCH, α-endosulfan, p, p’-DDE and TPL. A higher fraction of
CKDu patients presented in stage V CKD (66.34%). The presence of higher serum
levels of OCP in patients with CKDu in comparison to CKDk at their corresponding
CKD stages indicates their possible role in the etiopathogenesis of CKDu.
Author(s) Details:
C. Gothwaal,
Department of Medicine, University College of Medical Sciences and
Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
O.
P. Kalra,
Department
of Medicine, University College of Medical Sciences and Guru Teg Bahadur
Hospital, University of Delhi, Delhi, India.
S. Agarwal,
Department of Medicine, University College of Medical Sciences and
Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
A. Raizada,
Department of Medicine, University College of Medical Sciences and
Guru Teg Bahadur Hospital, University of Delhi, Delhi, India.
Please see the link here: https://stm.bookpi.org/ANUMS-V4/article/view/13171
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