A chronic kidney disorder of unknown origin, referred to as Chronic Kidney Disease of unknown etiology (CKDu), is leading to kidney failures in Hyderabad and nearby districts of Telangana, alarmingly affecting younger adults who are economically active and have no prior history of diabetes or high blood pressure.A team of senior nephrologists from Osmania General Hospital (OGH) and Apollo Hospitals studied 75 patients and published their findings in the Indian Journal of Nephrology (August 2024). The study revealed that while the disease resembles the mysterious kidney failures reported in Andhra Pradesh and other states, it shows a distinct, city-specific pattern of risk in Hyderabad.Mysterious Kidney Disease In HyderadabadA mysterious kidney condition, called chronic kidney disease of unknown etiology (CKDu), is increasingly being reported among younger, non-diabetic residents in Hyderabad and nearby districts of Telangana, a study led by nephrologists reveals. Unlike traditional CKDu cases, which are often associated with agricultural work and heat exposure, this urban group largely comprises small business owners and service-sector workers with no farming history.“Our research confirms the presence of the CKDu phenotype in Telangana, beyond the established hotspot regions, showing that an agricultural background is not required for the disease to develop,” said Dr. Manisha Sahay, Head of Nephrology at OGH and lead author of the study.While CKDu in other regions is typically linked to strenuous farm labor and heat exposure, clinical data from OGH indicate that different, non-occupational factors may be driving the disease in younger, economically active individuals with no farming history. The condition progresses silently, often only producing symptoms once the kidneys are severely damaged, making urgent treatment at hospitals like Osmania General Hospital necessary.What Is Chronic Kidney Disease Of Unknown Etiology?Chronic kidney disease of unknown etiology (CKDu) is a type of chronic kidney disease with no identifiable cause, commonly observed in agricultural communities in certain regions. It is believed to arise from multiple factors, including environmental exposures such as pesticides, heavy metals, heat stress, dehydration, and contaminated water. According to the International Society of Nephrology, CKDu is diagnosed when known risk factors for chronic kidney disease, such as diabetes and hypertension, are absent.What Are The Possible Causes Of Chronic Kidney Disease Of Unknown Etiology?While the exact cause of CKDu is not confirmed, researchers suggest several possible contributors. The disease is likely multifactorial, arising from a combination of factors rather than a single cause. Environmental toxins, including heavy metals, pesticides, and mycotoxins, are under investigation. Heat stress and repeated dehydration from strenuous work in hot climates may also damage kidney tubules. Other potential factors being studied include contaminated water supplies and viral infections.Kidney biopsies of patients at OGH revealed widespread scarring and inflammation in the kidney’s filtering units, indicating that the disease starts silently in this critical compartment.“The damage observed in these biopsies highlights the severe consequences of late diagnosis, a pattern seen consistently across all CKDu-affected regions. Since the disease remains largely asymptomatic in its early stages, patients often reach urban hospitals only when they urgently need dialysis or renal replacement therapy,” said Dr. Manisha Sahay, Head of Nephrology at OGH.CKDu in Hyderabad Linked To Urban Lifestyles and Unregulated Herbal Remedies“While globally, 60 to 80 percent of CKDu cases occur among agricultural workers, only 21.3 percent of the Hyderabad patients were involved in rice farming,” noted Dr. Manisha Sahay in the study. “This shows that the CKDu phenotype affects a broad range of individuals from non-agricultural backgrounds, including small business owners, service-sector employees, and urban residents.”Adding to the concern, 40 percent of patients in the OGH study reported using unregulated alternative or herbal medicines. Researchers emphasize that this widespread local practice may represent a significant risk factor, highlighting the need for urgent public health investigations targeting local dispensaries and providers of traditional remedies.
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