{"title":"“衰竭的星球上衰竭的肾脏;病因不明的CKD”。","authors":"Eleni Geladari, Natalia Vallianou, Charalampia Geladari, Konstantinos Aronis, Konstantinos Vlachos, Emmanuel Andreadis, Ioannis Theocharopoulos, Spyros Dourakis","doi":"10.1515/reveh-2021-0109","DOIUrl":null,"url":null,"abstract":"<p><p>The 'alarm clock' for human beings in the era of climate medicine has rung. Original diseases have appeared, that could not be explained and attributed to common causes, which are suggested to be linked to global warming and environmental factors. Such an indolent disease is the chronic kidney disease of unknown cause (CKDu), introduced also as Mesoamerican or Uddanam nephropathy. Scientists equate the climate impact on kidneys with the canary in the coal mine; coal miners used to carry caged canaries with them, so that if poisonous gases, such as methane or carbon monoxide leaked into the mine-shaft, the gases would kill the canary before killing the miners; similarly, kidneys are injured before devastating and lethal complications occur in humans. In some regions of Central America, the deaths due to chronic kidney disease increased by 177% with a death toll being as high as over 20,000. It was first documented in animals that periodic heat and dehydration have a major role in causing chronic kidney disease. Based on that observation, it is advocated that young male agricultural workers in Central America and South Asia, develop renal disease by getting exposed to extreme heat repeatedly. The clinico-pathological characteristics of this type of kidney injury, do not belong to an existing classification, even though a form of tubulo-interstitial renal disease has been proposed. In this review, we will discuss about CKDu, its epidemiology and pathophysiological mechanisms, clinical presentation and diagnostic biomarkers and examine potential therapeutic options.</p>","PeriodicalId":21165,"journal":{"name":"Reviews on Environmental Health","volume":"38 1","pages":"125-135"},"PeriodicalIF":3.0000,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"3","resultStr":"{\"title\":\"\\\"Failing kidneys in a failing planet; CKD of unknown origin\\\".\",\"authors\":\"Eleni Geladari, Natalia Vallianou, Charalampia Geladari, Konstantinos Aronis, Konstantinos Vlachos, Emmanuel Andreadis, Ioannis Theocharopoulos, Spyros Dourakis\",\"doi\":\"10.1515/reveh-2021-0109\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>The 'alarm clock' for human beings in the era of climate medicine has rung. Original diseases have appeared, that could not be explained and attributed to common causes, which are suggested to be linked to global warming and environmental factors. Such an indolent disease is the chronic kidney disease of unknown cause (CKDu), introduced also as Mesoamerican or Uddanam nephropathy. Scientists equate the climate impact on kidneys with the canary in the coal mine; coal miners used to carry caged canaries with them, so that if poisonous gases, such as methane or carbon monoxide leaked into the mine-shaft, the gases would kill the canary before killing the miners; similarly, kidneys are injured before devastating and lethal complications occur in humans. In some regions of Central America, the deaths due to chronic kidney disease increased by 177% with a death toll being as high as over 20,000. It was first documented in animals that periodic heat and dehydration have a major role in causing chronic kidney disease. Based on that observation, it is advocated that young male agricultural workers in Central America and South Asia, develop renal disease by getting exposed to extreme heat repeatedly. The clinico-pathological characteristics of this type of kidney injury, do not belong to an existing classification, even though a form of tubulo-interstitial renal disease has been proposed. In this review, we will discuss about CKDu, its epidemiology and pathophysiological mechanisms, clinical presentation and diagnostic biomarkers and examine potential therapeutic options.</p>\",\"PeriodicalId\":21165,\"journal\":{\"name\":\"Reviews on Environmental Health\",\"volume\":\"38 1\",\"pages\":\"125-135\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2023-03-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"3\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Reviews on Environmental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1515/reveh-2021-0109\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENVIRONMENTAL SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Reviews on Environmental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1515/reveh-2021-0109","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENVIRONMENTAL SCIENCES","Score":null,"Total":0}
"Failing kidneys in a failing planet; CKD of unknown origin".
The 'alarm clock' for human beings in the era of climate medicine has rung. Original diseases have appeared, that could not be explained and attributed to common causes, which are suggested to be linked to global warming and environmental factors. Such an indolent disease is the chronic kidney disease of unknown cause (CKDu), introduced also as Mesoamerican or Uddanam nephropathy. Scientists equate the climate impact on kidneys with the canary in the coal mine; coal miners used to carry caged canaries with them, so that if poisonous gases, such as methane or carbon monoxide leaked into the mine-shaft, the gases would kill the canary before killing the miners; similarly, kidneys are injured before devastating and lethal complications occur in humans. In some regions of Central America, the deaths due to chronic kidney disease increased by 177% with a death toll being as high as over 20,000. It was first documented in animals that periodic heat and dehydration have a major role in causing chronic kidney disease. Based on that observation, it is advocated that young male agricultural workers in Central America and South Asia, develop renal disease by getting exposed to extreme heat repeatedly. The clinico-pathological characteristics of this type of kidney injury, do not belong to an existing classification, even though a form of tubulo-interstitial renal disease has been proposed. In this review, we will discuss about CKDu, its epidemiology and pathophysiological mechanisms, clinical presentation and diagnostic biomarkers and examine potential therapeutic options.
期刊介绍:
Reviews on Environmental Health (REVEH) is an international peer-reviewed journal that aims to fill the need for publication of review articles on hot topics in the field of environmental health. Reviews on Environmental Health aims to be an inspiring forum for scientists, environmentalists, physicians, engineers, and students who are concerned with aspects of human health, including quality of life, that are determined by physiological and psychosociological interactions between man and physical, chemical, biological, and social factors in the environment.
Reviews on Environmental Health is an important niche served by no other journal, that’s being a site where thoughtful reviews can be published on a variety of subjects related to both health and environment. One challenge is to bridge the research on environmental causes of disease with the clinical practice of medicine. Reviews on Environmental Health is a source of integrated information on environment and health subjects that will be of value to the broad scientific community, whether students, junior and senior professionals, or clinicians.