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CHRONIC KIDNEY DISEASE CAUSES
Causes of
Chronic Kidney Disease
The pattern in developing countries of Asia, Africa, and Latin
America is quite different. Chronic glomerulonephritis and
hypertension are the dominant causes in Africa. In Asia,
diabetes mellitus—usually type 2—is almost as common a cause as
glomerulonephritis. Obstructive uropathy is a more common cause
than in Europe because of the higher incidence of tuberculosis,
schistosomiasis, urethral strictures, and
kidney
stone disease. Other diseases more common in these countries,
which may cause chronic
kidney
disease,
include systemic lupus erythematosus (especially in Asian
women), sickle-cell disease, and human immunodeficiency virus
(HIV) infection.
Glomerulonephritis
Primary glomerulonephritis and secondary inflammatory glomerular
disease Glomerulonephritis remains the most common cause of
chronic renal failure outside the United States, accounting for
34 per cent of new cases in Australia.
The
patients usually suffer the common chronic glomerulonephritides,
especially IgA disease, but including focal sclerosis,
membranous nephropathy, and mesangiocapillary nephritis.
These patients, more often males, are identified as marked for
end-stages kidney failure by heavy proteinuria, hypertension,
interstitial changes in their renal biopsy specimens, and early
and progressive renal dysfunction, in other words they have
severe disease.
Others have glomerular lesions secondary to systemic diseases
such as systemic lupus erythematosis, Henoch–Schönlein purpura,
systemic vasculitis, and, rarely, antiglomerular basement
membrane antibody disease (anti-GBM disease). Progression to
end-stages can be rapid or gradual after a severe acute
nephritic illness has been halted but leaving substantial
residual injury.
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