| Résumé | Kidney disease of unknown etiology (CKDu) has been identified in many countries extending from Mesoamerica and Egypt to South-east Asia and China. Although CKDu has been associated by various authors to farming, the association is an artifact of treating multimodal distributions as unimodal. There is NO correlation of CKDu with agriculture since affected farming villages are often surrounded by other farming villages free of CKDu. Initial studies looked for a correlation of CKDu with the presence of toxic heavy metal residues of arsenic, cadmium, etc., or herbicides like glyphosate as causative factors. There is now some consensus that their concentrations are below danger thresholds, be it in Mesoamerica or south-east Asia. The conceptual basis of a search for etiology within a systems approach is discussed, and names proposed for the disease that bias the identification of its etiology are reviewed. Current research has narrowed down the etiology to geochemical electrolytic contaminants like fluorides and ionic components in hard water, nanosilica, as well as renal toxins similar to indoxyl sulfates that may arise from interactions of ions with humic acids contained in aqueous organic matter. However, while agrochemical toxins are increasingly considered less relevant to the etiology of CKDu, it has become a firm public belief. In Sri Lanka, this has spawned ideology-based agricultural policies leading to partial and complete banning of agrochemicals followed by some back tracking, strongly disrupting the economy and the food supply. |
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