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John O, Gummudi B, Jha A, Gopalakrishnan N, Kalra OP, Kaur P, Kher V, Kumar V, Machiraju RS, Osborne N, Palo SK, Parameswaran S, Pati S, Prasad N, Rathore V, Rajapurkar MM, Sahay M, Tatapudi RR, Thakur JS, Venugopal V, Jha V. Chronic Kidney Disease of Unknown Etiology in India: What Do We Know and Where We Need to Go. Kidney Int Rep 2021; 6:2743-2751. [PMID: 34805627 PMCID: PMC8589686 DOI: 10.1016/j.ekir.2021.07.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Chronic kidney disease (CKD) not associated with known risk factors has been reported from parts of India and is presumed to be similar to CKD of unknown etiology (CKDu) that has been described from Central America. The reports from India have been fragmented without clear description of the disease phenotype or its determinants. This paper summarizes the current state of knowledge around CKDu in India based on a review of literature, multi-stakeholder consultation, and a survey of Indian nephrologists. We also contacted individual research groups to solicit data. Our findings suggest that that CKDu is reported from most regions in India; however, it is interpreted differently from the phenotype described from Central America and Sri Lanka. The differences include lack of a clear demographic or occupation group, older age of affected participants, and presence of mild hypertension and low-grade proteinuria. Well-designed prospective field studies with appropriate diagnostic workup are needed to establish the disease burden and identify etiologies, along with socioeconomic and health consequences, the intersection with the environment, and the public health response. Community-based research should phenotype the entire CKD population rather than be restricted to cases with presumed CKDu based on predefined criteria. Guidelines are needed for clinical evaluation, referral, management, and harmonization of clinical documentation and health records. More data are needed to support the existence of a unique CKDu phenotype in India.
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Affiliation(s)
- Oommen John
- George Institute for Global Health India, UNSW, New Delhi, India.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Balaji Gummudi
- George Institute for Global Health India, UNSW, New Delhi, India.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | - Anubhuti Jha
- George Institute for Global Health India, UNSW, New Delhi, India.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | | | - Om P Kalra
- Pt BD Sharma University of Health Sciences, Rohtak, India
| | | | - Vijay Kher
- Medanta Kidney & Urology Institute, Medanta the Medicity, Gurugram, India
| | - Vivek Kumar
- Department of Nephrology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Nicolas Osborne
- School of Public Health University of Queensland Herston Australia.,School of Population Health University of New South Wales Australia
| | | | - Sreejith Parameswaran
- Jawaharlal Institute of Postgraduate Medical Education & Research, Puducherry, India
| | | | - Narayan Prasad
- Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Vinay Rathore
- All India Institute of Medical Sciences, Raipur, India
| | | | - Manisha Sahay
- Department of Nephrology, Osmania General Hospital, Hyderabad, India
| | | | - Jarnail S Thakur
- School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vidhya Venugopal
- Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Vivekanand Jha
- George Institute for Global Health India, UNSW, New Delhi, India.,Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.,School of Public Health, Imperial College, London, UK
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Abouee-Mehrizi A, Rasoulzadeh Y, Kazemi T, Mesgari-Abbasi M. Inflammatory and immunological changes caused by noise exposure: A systematic review. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, TOXICOLOGY AND CARCINOGENESIS 2020; 38:61-90. [PMID: 32397946 DOI: 10.1080/26896583.2020.1715713] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Today, due to the growth of industries and spread of the use of various instruments and devices that produce high noise levels, it is necessary to pay more attention to the effects of exposure to noise on organs and tissues in the body. The importance of the immune system in fighting external and pathogenic factors has raised the need to consider external factors (such as harmful physical factors) and make efforts to avoid producing them. In this systematic review, 811 potentially relevant studies were found in Google Scholar, PubMed, and Web of Science databases, of which 32 different English-written articles were included in the study. The method of searching and systematically reviewing articles was based on the assessment tool of the multiple systematic reviews (AMSTAR) method. The results of this study suggested that noise could affect the function of the immune system and its components by affecting other systems and organs of the body, including the central nervous system, auditory system, circulatory system, and endocrine gland. Moreover, it can be hypothesized that noise affects immune system by producing the NADPH oxidase (Nox) and reactive oxygen species (ROS).
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Affiliation(s)
- Amirreza Abouee-Mehrizi
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yahya Rasoulzadeh
- Department of Occupational Health Engineering, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Tohid Kazemi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehran Mesgari-Abbasi
- Drug Applied Research Center (DARC), Tabriz University of Medical Sciences, Tabriz, Iran
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