Show Summary Details
Page of

Chronic Interstitial Nephritis in Agricultural Communities 

Chronic Interstitial Nephritis in Agricultural Communities
Chapter:
Chronic Interstitial Nephritis in Agricultural Communities
Author(s):

Channa Jayasumana

, Carlos Orantes

, and Marc E. De Broe

DOI:
10.1093/med/9780199592548.003.0366_update_001

Update:

Introduction of new material regarding Chronic Interstitial Nephritis in Agricultural Communities

Page of

PRINTED FROM OXFORD MEDICINE ONLINE (www.oxfordmedicine.com). © Oxford University Press, 2016. All Rights Reserved. Under the terms of the licence agreement, an individual user may print out a PDF of a single chapter of a title in Oxford Medicine Online for personal use (for details see Privacy Policy and Legal Notice).

date: 18 November 2018

Chronic Interstitial Nephritis in Agricultural Communities (CINAC) has been increasingly recognized since the early 1990s. It has been called epidemic chronic kidney disease unknown cause (CKDu) in Sri Lanka, and meso-American nephropathy in Central America. CINAC occurs regionally in the Tropics, predominantly in rural/agricultural zones. It is increasingly recognized, but also believed to be increasing in incidence. Men are affected up to three times more often than women. Its incidence increases with age, and a number of other epidemiological factors impact on it. In some areas, such as the North Central Province of Sri Lanka and regions of Central America, it drives extreme rates of CKD and end-stage renal failure. Clinically, it has the non-specific characteristics of other slowly-evolving chronic interstitial nephritis (Chapter 86). Perhaps distinctive is an inconsistent history of episodes of dysuria, sometimes loin pain, in earlier disease. Its aetiology remains unsolved. Maps of incidence commonly show a mosaic pattern, suggesting that exposure to local factors are implicated. It has been associated with working outdoors in high temperatures, but this seems inadequate as the sole explanation. Exposure to nephrotoxins, natural or possibly as agrochemicals, seems likely.

Access to the complete content on Oxford Medicine Online requires a subscription or purchase. Public users are able to search the site and view the abstracts for each book and chapter without a subscription.

Please subscribe or login to access full text content.

If you have purchased a print title that contains an access token, please see the token for information about how to register your code.

For questions on access or troubleshooting, please check our FAQs, and if you can't find the answer there, please contact us.