RTI International, Research Triangle Park, NC, USA.
RTI International, Research Triangle Park, NC, USA.
Environ Res. 2021 Jan;192:110270. doi: 10.1016/j.envres.2020.110270. Epub 2020 Oct 7.
The incidence of chronic kidney disease of unknown or uncertain etiology (CKDu) is recognized as a global non-communicable health crisis. The goal of this work is to compare the types of research studies in Latin America and Asia, two regions with increasing CKDu incidence.
A comparative literature review was conducted to evaluate the CKDu research design for peer-reviewed articles published from 2015 to 2019. Full texts were reviewed to identify study location, study type, study design, risk factors evaluated, and if applicable, sample type and number.
In Asia and Latin America, 82 and 65 articles were identified in total, respectively, with 55 field studies in Asia versus 34 in Latin America. In Asia, research was focused on drinking water (34), heavy metals (20), and agrochemical product usage (19) as potential risk factors. In Latin America, research focused mostly on heat stress/dehydration (36) and agrochemical product usage (18) as potential CKDu risk factors. Biological samples were collected more frequently than environmental samples, especially in Latin America.
Research to pinpoint the risk factors associated with CKDu to date is not standardized and typically limited in geographical scope. The emphasis of CKDu research varies by geographic region, with a greater priority placed on water quality and chemical exposure in Asia, versus dehydration and heat stress in Latin America. Using a harmonized approach to CKDu research would yield improved understanding of the risk factors associated with CKDu and how they compare across affected regions.
病因不明或不确定的慢性肾脏病（CKDu）的发病率被认为是全球非传染性健康危机。本研究的目的是比较拉丁美洲和亚洲两个 CKDu 发病率不断上升的地区的研究类型。
对 2015 年至 2019 年发表的同行评审文章进行了比较文献综述，以评估 CKDu 的研究设计。对全文进行了回顾，以确定研究地点、研究类型、研究设计、评估的危险因素以及是否适用样本类型和数量。
在亚洲和拉丁美洲，共确定了 82 篇和 65 篇文章，亚洲有 55 篇现场研究，拉丁美洲有 34 篇。在亚洲，研究集中在饮用水（34 篇）、重金属（20 篇）和农用化学品使用（19 篇）作为潜在的危险因素。在拉丁美洲，研究主要集中在热应激/脱水（36 篇）和农用化学品使用（18 篇）作为潜在的 CKDu 危险因素。与环境样本相比，生物样本的采集频率更高，尤其是在拉丁美洲。
迄今为止，确定与 CKDu 相关的危险因素的研究尚未标准化，且通常限于地理范围。CKDu 研究的重点因地理区域而异，亚洲更侧重于水质和化学物质暴露，而拉丁美洲则更侧重于脱水和热应激。采用统一的 CKDu 研究方法将提高对与 CKDu 相关的危险因素的认识，并了解它们在受影响地区的差异。
