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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 PLoS+One
2018 ; 13
(3
): e0193056
Nephropedia Template TP
gab.com Text
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English Wikipedia
Morphological and clinical findings in Sri Lankan patients with chronic kidney
disease of unknown cause (CKDu): Similarities and differences with Mesoamerican
Nephropathy
#MMPMID29513702
Wijkström J
; Jayasumana C
; Dassanayake R
; Priyawardane N
; Godakanda N
; Siribaddana S
; Ring A
; Hultenby K
; Söderberg M
; Elinder CG
; Wernerson A
PLoS One
2018[]; 13
(3
): e0193056
PMID29513702
show ga
In Sri Lanka, an endemic of chronic kidney disease of unknown origin (CKDu) is
affecting rural communities. The endemic has similarities with Mesoamerican
Nephropathy (MeN) in Central America, however it has not yet been clarified if
the endemics are related diagnostic entities. We designed this study of kidney
biopsies from patients with CKDu in Sri Lanka to compare with MeN morphology.
Eleven patients with CKDu were recruited at the General Hospital, Polonnaruwa,
using similar inclusion and exclusion criteria as our previous MeN studies.
Inclusion criteria were 20-65 years of age and plasma creatinine 100-220 ?mol/L.
Exclusion criteria were diabetes mellitus, uncontrolled hypertension and
albuminuria >1g/24h. Kidney biopsies, blood and urine samples were collected, and
participants answered a questionnaire. Included participants were between 27-61
years of age and had a mean eGFR of 38±14 ml/min/1.73m2. Main findings in the
biopsies were chronic glomerular and tubulointerstitial damage with
glomerulosclerosis (8-75%), glomerular hypertrophy and mild to moderate
tubulointerstitial changes. The morphology was more heterogeneous and
interstitial inflammation and vascular changes were more common compared to our
previous studies of MeN. In two patients the biopsies showed morphological signs
of acute pyelonephritis but urine cultures were negative. Electrolyte
disturbances with low levels of serum sodium, potassium, and/or magnesium were
common. In the urine, only four patients displayed albuminuria, but many patients
exhibited elevated ?-1-microglobulin and magnesium levels. This is the first
study reporting detailed biochemical and clinical data together with renal
morphology, including electron microscopy, from Sri Lankan patients with CKDu.
Our data show that there are many similarities in the biochemical and
morphological profile of the CKDu endemics in Central America and Sri Lanka,
supporting a common etiology. However, there are differences, such as a more
mixed morphology, more interstitial inflammation and vascular changes in Sri
Lankan patients.