Nayak Swetalina, Rehman Tanveer, Patel Kripalini, Dash Pujarini, Alice Alice, Kanungo Srikanta, Palo Subrata Kumar, Pati Sanghamitra
ICMR-Regional Medical Research Center, Bhubaneswar 751023, India.
Healthcare (Basel). 2023 Feb 13;11(4):551. doi: 10.3390/healthcare11040551.
(1) Background: Despite ample research, the factors, specific causes, and pathways associated with chronic kidney disease of unknown etiology (CKDu) remain elusive. Therefore, we performed a systematic review to explore the potential etiologies for the development of CKDu globally. (2) Methods: A systematic literature review was conducted using databases CINAHL, Cochrane Library, Embase, Google Scholar, MEDLINE, and PsycINFO on the specific causes and pathophysiology related to CKDu from inception until April 2021. Study selection, data extraction of included articles, and quality appraisal were assessed. The narrative approach was used to summarize and comprehend the findings. (3) Results: Our study included 25 studies, considering 38,351 participants. Twelve studies were case-control, ten were cross-sectional, and three were cohort designs. All articles were from low-and middle-income countries (LMICs). The findings suggest 12 factors are associated with CKDu. Most studies ( = 8) identified farming and water sources as the factors related to CKDu, with heavy metal toxicity coming in second ( = 7). (4) Conclusion: The systematic review reported various factors associated with CKDu, from which most studies reported farming, water sources, and heavy metal poisoning. Considering the findings, the study recommends future strategies and public health initiatives to prevent the epidemiological/environmental factors contributing to CKDu.
(1) 背景：尽管进行了大量研究，但与病因不明的慢性肾脏病（CKDu）相关的因素、具体病因和发病途径仍不明确。因此，我们进行了一项系统综述，以探索全球范围内CKDu发生发展的潜在病因。(2) 方法：使用CINAHL、Cochrane图书馆、Embase、谷歌学术、MEDLINE和PsycINFO数据库，对从数据库建立至2021年4月期间与CKDu相关的具体病因和病理生理学进行系统的文献综述。评估了研究选择、纳入文章的数据提取以及质量评估。采用叙述性方法总结和理解研究结果。(3) 结果：我们的研究纳入了25项研究，涉及38351名参与者。其中12项为病例对照研究，10项为横断面研究，3项为队列研究设计。所有文章均来自低收入和中等收入国家（LMICs）。研究结果表明有12个因素与CKDu相关。大多数研究（n = 8）确定农业生产和水源是与CKDu相关的因素，重金属毒性位居第二（n = 7）。(4) 结论：该系统综述报告了与CKDu相关的各种因素，其中大多数研究报告了农业生产、水源和重金属中毒。基于这些研究结果，该研究建议未来制定相关策略和开展公共卫生倡议，以预防导致CKDu的流行病学/环境因素。
