Attempts to Change the Globally Accepted Term, CKDu, to KDUCAL, NUCAL, or CINAC Are Inappropriate

We are concerned about the suggestion by Drs Subramanian and Javaid in AJKD1 and elsewhere2 to replace the term chronic kidney disease (CKD) of unknown origin (CKDu), which affects Sri Lanka and several tropical countries, with "kidney disease of unknown cause in agricultural laborers" (KDUCAL) and to replace Mesoamerican nephropathy (MeN) with "nephropathy of unknown cause in agricultural laborers" (NUCAL). These terms, as well as chronic interstitial nephritis in agricultural communities (CINAC)3 and "agrochemical nephropathy,"4 imply that CKDu affects only agricultural laborers exposed to agrochemicals.

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