A recent study has highlighted the increasing prevalence of chronic kidney disease of unknown etiology (CKDu) in Telangana, particularly in urban areas like Hyderabad. This condition is significantly impacting younger individuals who typically do not present with traditional risk factors such as diabetes or hypertension, which are commonly associated with chronic kidney disease (CKD).
The research, led by senior nephrologists at the government-run Osmania General Hospital and Apollo Hospitals, involved a detailed examination of 75 patients and was published in the Indian Journal of Nephrology in August 2024. Conducted between March 2021 and November 2022, this single-center, prospective observational study aimed to document the clinical and epidemiological characteristics of CKDu patients in this region and to evaluate their kidney histology.
Among the 75 participants, the average age was 41.7 years, with 68% being male. Notably, 77.3% relied on groundwater as their main source of drinking water. The study also noted that 40% of the patients had previously used alternative medicine, and 46.6% underwent kidney biopsies. The histological examination revealed alarming findings: 54% exhibited global glomerulosclerosis, indicating that over half of the filtering units of the kidneys were scarred and dysfunctional.
Furthermore, approximately 31% of patients were found to have interstitial fibrosis and tubular atrophy, conditions where the spaces between kidney cells become hardened and the filtering tubules shrink. The study also documented that 34.3% of patients experienced periglomerular fibrosis, or scarring around the kidney”s filters, and 85.7% showed signs of interstitial inflammation, which points to swelling and irritation within kidney tissues.
Dr. Manisha Sahay, Head of Nephrology at Osmania General Hospital, emphasized that the key takeaway from this study is the identification of CKD cases that fit the CKDu profile outside of known hotspots, indicating a broader issue in Telangana beyond traditional agricultural risks. “These cases are not confined to those involved in farming,” she stated, underscoring the significance of these findings.
Among the patients assessed, 69% were non-oliguric, maintaining a normal urine output despite kidney issues. Additionally, 28% experienced nocturia, which involves waking up multiple times at night to urinate, and 77.3% reported feelings of fatigue or weakness. Swelling, medically termed oedema, was noted in 13.3% of the patients. Most of the subjects were from Hyderabad, comprising 42.7% of the study group, followed by those from Rangareddy district at 10%.
Another concerning statistic revealed that 33% of the participants had hyperuricemia, characterized by elevated uric acid levels in the blood. Alarmingly, 40% were already in stage 5 chronic kidney disease, the most advanced stage, and seven patients (9.3%) required renal replacement therapy, including dialysis, at the time of their diagnosis.
