Chronic kidney disease of undetermined aetiology: tens of thousands of premature deaths, yet too much remains unknown.

Tens of thousands of working-age adults have been dying from unexplained end-stage renal disease (ESRD) in Central America and South Asia. As the cause of this chronic kidney disease (CKD) remains unknown, the condition(s) (a unified aetiopathology has not been confirmed) has been termed ‘CKD of undetermined aetiology’ (CKDu). ‘CKD of non-traditional aetiology’, ‘chronic interstitial nephritis in agricultural communities’, ‘Mesoamerican nephropathy’, ‘Sri Lankan agricultural nephropathy’ and ‘Uddanam nephropathy’ are also used, but here we use the term CKDu.