Chronic Interstitial Nephritis in Agricultural Communities: Observational and Mechanistic Evidence Supporting the Role of Nephrotoxic Agrochemicals.
| Autor: | Holliday MW Jr; Michael E. DeBakey VA Medical Center and Baylor College of Medicine, Houston, Texas., Majeti RN; The Center for Convergent Bioscience and Medicine (CCBM), The University of Alabama, Tuscaloosa, Alabama., Sheikh-Hamad D; Baylor College of Medicine, Houston, Texas. |
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| Jazyk: | angličtina |
| Zdroj: | Clinical journal of the American Society of Nephrology : CJASN [Clin J Am Soc Nephrol] 2024 Apr 01; Vol. 19 (4), pp. 538-545. Date of Electronic Publication: 2023 Sep 06. |
| DOI: | 10.2215/CJN.0000000000000312 |
| Abstrakt: | Chronic interstitial nephritis in agricultural communities (CINAC) is an epidemic of kidney disease affecting specific tropical and subtropical regions worldwide and is characterized by progressive CKD in the absence of traditional risk factors, such as hypertension and diabetes. CINAC prevalence is higher among young, male agricultural workers, but it also affects women, children, and nonagricultural workers in affected areas. Biopsies from patients with CINAC across regions commonly demonstrate tubular injury with lysosomal aggregates, tubulointerstitial inflammation, and fibrosis and variable glomerular changes. Each endemic area holds environmental risk factors and patient/genetic milieus, resulting in uncertainty about the cause(s) of the disease. Currently, there is no specific treatment available for CINAC. We highlight survey findings of Houston-based migrant workers with CINAC and draw similarities between kidney injury phenotype of patients with CINAC and mice treated chronically with paraquat, an herbicide used worldwide. We propose potential pathways and mechanisms for kidney injury in patients with CINAC, which may offer clues for potential therapies. (Copyright © 2023 by the American Society of Nephrology.) |
| Databáze: | MEDLINE |
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