Anthropological perspectives on CKDnt in Mexico: time for a paradigm shift on the social determinants of health

Abstract

In Mexico, the kidneys of individuals in poor and marginalized communities are failing with little warning and no explanation. Commonly referred to as chronic kidney disease of non-traditional origin (CKDnt), this new variant of kidney disease cannot be accounted for by conventional or discrete etiological explanations, but is instead understood to be a consequence of economic development, environmental degradation and precarious working and living conditions. Drawing on two interconnected ethnographic studies, and the intertwining problems of causation and care, this paper will (1) document the social conditions of disease emergence around Lake Chapala, Central Mexico, and (2) follow the haphazard routes kidney patients take to access resource-intensive biotechnical treatments. Its aim is to both challenge and reconceptualize social determinants as social relations in order to fully account for the profoundly contextual, temporal, and dynamic character of this condition, and to rethink opportunities for care and intervention.

Characteristics and clinical outcomes of patients with kidney failure of unknown aetiology from ANZDATA registry

“…This difference in uESKD prevalence is likely multifactorial in the context of different occupational and environmental exposures; and access/utilisation of advanced diagnostic tests such as genetic testing. The high prevalence of uESKD in Mexico has been linked to intense work in strong heat, increased environmental degradation with exposure to heavy metals, widespread use of pesticides and reduced access to diagnostic testing to identify the cause of kidney failure [ 11 ].…”