{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T14:57:21Z","timestamp":1791903441998,"version":"4.3.4"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T00:00:00Z","timestamp":1787184000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Chronic kidney disease of non\u2010traditional aetiology (CKDu) has been described in agricultural regions worldwide, yet its contribution to renal mortality in Mexico remains poorly characterised. This study aimed to characterise renal mortality trends in Chiapas and evaluate the autonomy of CKDu relative to metabolic causes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method(s)<\/jats:title>\n                    <jats:p>\n                      An ecological time\u2010series study used DGIS mortality microdata for Chiapas, 2000\u20132024. Renal deaths (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200946\u2009301) were classified by ICD\u201010 into DKD, HN, CKDu, ReNe and OthR. Age strata were 0\u201314, 15\u201329, 30\u201344, 45\u201359 and \u2265\u200960\u2009years. Age\u2010standardised mortality rates were calculated, APC estimated using log\u2010linear regression, and sociodemographic contrasts assessed using binomial logistic regression (CKDu vs. DKD). Temporal independence between CKDu and diabetes trends was evaluated using trend\u2010correlation and a binomial test for diagnostic substitution.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among individuals aged 15\u201344\u2009years, CKDu was the leading renal cause of death (44.2%), compared with 27.5% for DKD. CKDu comprised 32.9% of renal deaths in men versus 26.2% in women. The highest mortality growth occurred in men aged 30\u201344\u2009years (APC 4.01%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Among agricultural\u2010sector decedents, mortality was more likely to be attributed to CKDu than DKD (OR 1.61). HN showed the fastest overall growth (APC 6.72%). Trend\u2010correlation indicated that 64.5% of CKDu temporal variance was independent of diabetes trends (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.3547), with no evidence of diagnostic substitution (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.7).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Renal mortality in Chiapas shows a dual burden in which CKDu exhibits autonomy, consistent with chronic interstitial nephritis in agricultural communities, and supports surveillance and prevention addressing occupational and environmental determinants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nep.70269","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T11:42:16Z","timestamp":1787226136000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Epidemiological Transition of Renal Mortality in Chiapas (2000\u20132024): Autonomy of\n                    <scp>CKDu<\/scp>\n                    and the Rise of Hypertensive Nephropathy\u2014A Time\u2010Series Ecological Study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-529X","authenticated-orcid":false,"given":"Francisco Emmanuel Arce","family":"Moguel","sequence":"first","affiliation":[{"name":"Department of Health El Colegio de la Frontera Sur (ECOSUR)  San Crist\u00f3bal de Las Casas Chiapas Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5950-7840","authenticated-orcid":false,"given":"Benito Salvatierra","family":"Izaba","sequence":"additional","affiliation":[{"name":"Department of Health El Colegio de la Frontera Sur (ECOSUR)  San Crist\u00f3bal de Las Casas Chiapas Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-023-03340-w"},{"issue":"10258","key":"e_1_2_11_3_1","first-page":"1209","article-title":"Global Burden of Disease Study 2019","volume":"395","author":"Institute for Health Metrics and Evaluation (IHME)","year":"2020","journal-title":"Lancet"},{"issue":"3","key":"e_1_2_11_4_1","first-page":"323","article-title":"Chronic Kidney Disease of Unknown Etiology (CKDu): A Comprehensive Review of the Current Evidence","volume":"13","author":"Vervaet B. 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