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2015 ; 25
(5
): 274-80
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Endemic chronic kidney disease of unknown etiology in Sri Lanka: Correlation of
pathology with clinical stages
#MMPMID26628792
Wijetunge S
; Ratnatunga NV
; Abeysekera TD
; Wazil AW
; Selvarajah M
Indian J Nephrol
2015[Sep]; 25
(5
): 274-80
PMID26628792
show ga
Chronic kidney disease of unknown etiology (CKDU) is endemic among the rural
farming communities in several localities in and around the North Central region
of Sri Lanka. This is an interstitial type renal disease and typically has an
insidious onset and slow progression. This study was conducted to identify the
pathological features in the different clinical stages of CKDU. This is a
retrospective study of 251 renal biopsies identified to have a primary
interstitial disease from regions endemic for CKDU. Pathological features were
assessed and graded in relation to the clinical stage. The mean age of those
affected by endemic CKDU was 37.3 ± 12.5 years and the male to female ratio was
3.3:1. The predominant feature of stage I disease was mild and moderate
interstitial fibrosis; most did not have interstitial inflammation. The typical
stage II disease had moderate interstitial fibrosis with or without mild
interstitial inflammation. Stage III disease had moderate and severe interstitial
fibrosis, moderate interstitial inflammation, tubular atrophy and some
glomerulosclerosis. Stage IV disease typically had severe interstitial fibrosis
and inflammation, tubular atrophy and glomerulosclerosis. The mean age of
patients with stage I disease (27 ± 10.8 years) was significantly lower than
those of the other stages. About 79.2%, 55%, 49.1% and 50% in stage I, II, III
and IV disease respectively were asymptomatic at the time of biopsy.