Heavy Metal Exposure and Chronic Kidney Disease of Unknown Origin (Ckdu): An Emerging Environmental Nephropathy

Abstract

Background: Chronic kidney disease of unknown origin (CKDu) is increasingly recognized as a public health concern in agricultural and industrial regions. Emerging evidence suggests that environmental exposure to heavy metals may play a critical role.
Objective: To evaluate the association between heavy metal exposure (lead, cadmium, arsenic) and CKDu in patients attending a tertiary care hospital.
Methods: A cross-sectional study was conducted between January 2024 and March 2025 involving 120 CKDu patients. Serum and urinary heavy metal levels were measured and compared to age- and sex-matched controls. Demographic, occupational, and clinical data were also collected.
Results: Mean blood lead and urinary cadmium levels were significantly higher in the CKDu group compared to controls (p < 0.01). A strong correlation was found between duration of occupational exposure and severity of kidney dysfunction (r = 0.71). Arsenic exposure was observed predominantly in patients using unregulated groundwater.
Conclusion: Chronic exposure to environmental heavy metals is significantly associated with CKDu. This finding highlights the need for environmental surveillance, early screening, and regulatory intervention in vulnerable populations.