Epidemiology, molecular, and genetic methodologies to evaluate causes of CKDu around the world: report of the Working Group from the ISN International Consortium of Collaborators on CKDu

Twenty years ago, nephrologists working in El Salvador and Sri Lanka described a progressive kidney disease leading to devastatingly high rates of death from kidney failure in young and middle-aged individuals.1,2 Other descriptions including documentaries and press reports brought chronic kidney disease of unknown etiology (CKDu) to the world’s attention, presenting the toll on working families unable to afford kidney replacement therapy.3 Additional regions with a similar profile of kidney disease have since been discovered, but few rigorous studies have been performed to investigate candidate hypotheses. Research has been challenging because of political circumstances, the marginalized nature of populations afflicted, and the scarcity of personnel and funding.