Abstract

Incidence of chronic kidney disease of unknown etiology (CKDu) has emerged in South Asia and sub-Saharan Africa over last few years. CKDu is not attributed to diabetes, hypertension or other known causes of CKD. It affects younger individuals and is usually asymptomatic till advanced stages. Organochlorine pesticides (OCPs) are one of the proposed etiologies of CKDu. The present study was done to evaluate the serum level of certain commonly encountered OCPs (α-HCH, β-HCH, g-HCH, total HCH, Aldrin, Dieldrin, α- endosulfan, β-endosulfan, p,p’-DDT, p,p’-DDE) and total pesticide load (TPL) in patients with CKDu in comparison to patients with CKD of known etiology (CKDk) and to assess their correlation, if any. It was a case-control, cross-sectional study conducted in East Delhi. Subjects within the age group 18-60 years were enrolled under 3 groups: Group I: Healthy controls (n=30), Group II: Patients with CKDu (n=30), and Group III: Patients with CKDk (n=30). Detailed history, physical examination and routine investigations were done. OCP levels were estimated in all subjects by high performance liquid chromatography. The median serum levels of all OCPs were found higher in patients of CKDu in comparison to other groups. The difference was statistically significant for α-HCH, β-HCH, total HCH, α-endosulfan, p,p’-DDE and TPL. Higher fraction of CKDu patients presented in stage V CKD (66.34%). The presence of higher serum levels of OCP in patients with CKDu in comparison to CKDk at their corresponding CKD stages indicates their possible role in the etiopathogenesis of CKDu.

Key words: CKD of unknown etiology, etiopathogenesis, organochlorine pesticides.