Socioeconomic and Lifestyle Factors Associated with the Prevalence of CKD of Unknown Etiology: A Cross-Sectional Study in Rural Populations

Background: Chronic kidney disease of unknown etiology (CKDu) has emerged as a major public health concern in rural agricultural communities of low- and middle-income countries, occurring independently of traditional risk factors such as diabetes and hypertension. Socioeconomic disadvantage, occupational heat stress, dehydration, and environmental exposures are thought to contribute to disease development, yet population-based data from Bangladesh remain limited. This study aimed to determine the prevalence of CKDu and explore associated socioeconomic and lifestyle factors in a rural Bangladeshi population. Methods: A community-based cross-sectional study was conducted in Baidyerbazar Union, Sonargaon Upazila, Narayanganj District, Bangladesh, utilizing an ongoing chronic kidney disease screening and awareness program of the Kidney Care and Research Center. Adult participants underwent clinical assessment and laboratory evaluation, including serum creatinine, estimated glomerular filtration rate (eGFR), and albumin-to-creatinine ratio (ACR). Follow-up assessment was performed after three months to evaluate persistence of renal impairment. Results: A total of 303 participants were enrolled, with a mean age of 41.3 ± 12.7 years; 63.4% were female. The cohort was predominantly normotensive, with mean blood pressure of 123/76 mmHg, and had a low prevalence of diabetes (9.9%) and hypertension (14.9%). Baseline renal function was largely preserved (mean eGFR 102 ± 20 mL/min/1.73 m²), with 96% of participants classified as GFR categories G1–G2. Overall chronic kidney disease prevalence decreased significantly from 16.8% at baseline to 10.2% at follow-up (p < 0.001), suggesting transient or reversible renal dysfunction in a subset of individuals. Conclusion: This study demonstrates early, potentially reversible renal impairment in a young, normotensive rural population, supporting the role of non-traditional and modifiable environmental or occupational factors in CKDu. Strengthening preventive surveillance and targeted public health interventions is essential to mitigate CKDu risk in vulnerable rural communities.