{"id":112876,"date":"2025-11-03T10:38:12","date_gmt":"2025-11-03T10:38:12","guid":{"rendered":"https:\/\/www.newsbeep.com\/il\/112876\/"},"modified":"2025-11-03T10:38:12","modified_gmt":"2025-11-03T10:38:12","slug":"kidney-disease-mystery-in-telangana-unprescribed-alternative-herbal-medicines-among-culprits-the-south-first","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/il\/112876\/","title":{"rendered":"Kidney disease mystery in Telangana: Unprescribed alternative herbal medicines among culprits – The South First"},"content":{"rendered":"

Indians take a lot of alternative medicines. They don’t even go to licensed practitioners. Without any prescription, they take medicines, some liquid, some ‘bhasma’ or powder\u2014often because a friend or relative had recommended it. <\/p>\n

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Published Nov 03, 2025 | 7:00 AM \u268a Updated Nov 03, 2025 | 10:33 AM<\/p>\n


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\"Chronic<\/p>\n

Among the 30 patients who admitted to have used alternative medicines, 43% consumed preparations in leaf form, 30% took powders, 16% drank liquids, and 10% swallowed tablets.<\/p>\n

Synopsis: A study, \u2018Chronic Kidney Disease of Unknown Etiology in Telangana: Is It Different?\u2019, has shed light on a major concern causing kidney diseases in Telangana. It is the use of un-prescribed and unscientific use of herbal remedies.<\/p>\n

Despite repeated warnings against the use of unprescribed herbal remedies, people are still using them, much to the chagrin of medical practitioners.<\/p>\n

Doctors at the Osmania General Hospital noticed several patients complaining of fatigue and, at times, swelling, between March 2021 and November 2022. They all had a common problem: compromised kidneys.<\/p>\n

Further investigation revealed something unexpected. None of them had worked in agricultural fields, handled pesticides or lived in areas known to have contaminated water, the usual suspects behind renal ailment. Doctors, however, found that 40 percent of them had used alternative herbal \u2018medicines\u2019.<\/p>\n

This was revealed in a study, Chronic Kidney Disease of Unknown Etiology in Telangana: Is it Different?<\/a>, published in the Indian Journal of Nephrology. It documented the first cases of Chronic Kidney Disease of unknown etiology (CKDu) in Telangana. The findings challenge assumptions about who develops this condition and why.<\/p>\n

\u201cPeople in India take a lot of alternative medicines for all sorts of reasons. They don\u2019t even go to licensed practitioners. Without any prescription, they take medicines, some liquid, some bhasma (calcinated stones, gems, minerals or metals) or powder\u2014often because a friend or relative had recommended it,\u201d Dr Manisha Sahay, Professor of Nephrology at Osmania Medical College, told South First.<\/p>\n

Dr Sahay and Dr Anitha Ramavajula, who led a team of researchers, tracked patients from urban and semi-urban areas; 42.7% came from Hyderabad, 10% from Ranga Reddy district. Only 21.3% had agricultural backgrounds.<\/p>\n

Also Read: South India reports an alarming Chronic Kidney Disease prevalence<\/a>
\nPattern that broke expectations<\/p>\n

CKDu appeared in sugarcane workers labouring under extreme heat across the world. Indian researchers later identified clusters in Uddanam, Andhra Pradesh, where young men working in farms developed kidney failure. Studies from Sri Lanka, Puducherry, and Tamil Nadu reported similar patterns and connections: agricultural workers, exposure to pesticides, and contaminated drinking water.<\/p>\n

Cases in Telangana, however, followed a different trajectory.<\/p>\n

\u201cIn some regions, it\u2019s (CKDu) common among agricultural workers. But our study revealed that most patients were not from agricultural backgrounds. About 40 percent of our patients had a history of taking unlicensed alternative medicines, powders or bhasmas from people without medical registration, which is unfortunately a very common practice in India,\u201d Dr Sahay said.<\/p>\n

Among the 30 patients who admitted to have used alternative medicines, 43% consumed preparations in leaf form, 30 percent took powders, 16 percent drank liquids, and 10 percent swallowed tablets.<\/p>\n

People sought these remedies for infertility, haemorrhoids, and joint pains. Many purchased these \u2018medicines\u2019 from local practitioners or shops selling traditional preparations.<\/p>\n

\u201cWhen we asked for prescriptions or proof that the medicines were prescribed by registered doctors, there were none,\u201d Dr Sahay said.<\/p>\n

\u201cHerbal or alternative medicine intake emerged as a major risk factor,\u201d the study noted.<\/p>\n

Also Read: Are your kidneys okay?<\/a>
\nWhat the biopsies revealed<\/p>\n

Biopsies on 35 patients told a story of prolonged, silent destruction.<\/p>\n

All biopsies showed chronic tubulointerstitial nephritis, which means inflammation lodged between the kidney tubules rather than in the filtering units themselves. In 31.4 percent of the cases, interstitial fibrosis and tubular atrophy affected more than half the kidney tissue. Another 45.7 percent showed damage across 25-50 percent of the tissue.<\/p>\n

\u201cThe kidney biopsies in our patients showed global glomerulosclerosis, meaning scarring and permanent kidney damage. That\u2019s why CKD occurs because the kidney tissue is already damaged. What\u2019s causing that damage is what we are trying to find out,\u201d Dr Sahay said.<\/p>\n

The severity of scarring correlated with blood creatinine levels, indicating how far the kidney function had declined. Fifty-four per cent displayed global glomerulosclerosis, where filtering units had hardened and ceased functioning.<\/p>\n

\u201cThe chronicity in CKDu biopsies indicated the relatively asymptomatic early phase of this disease,\u201d the researchers noted.<\/p>\n

The damage resembled what doctors observe in chronic interstitial nephritis in agricultural communities (CINAC), a condition documented in El Salvador and Egypt. But patients in Telangana developed it without engaging in farming.<\/p>\n

Also Read: 1 in 5 children in Telangana has impaired kidney function<\/a>
\nA global puzzle<\/p>\n

Dr Sahay explained that this phenomenon extended beyond India\u2019s borders.<\/p>\n

\u201cInterestingly, the same type of kidney injury is being reported among young people across the world, even among those who have never taken alternative medicines. So it\u2019s not just an Indian problem. In our study, 40 percent had taken unlicensed alternative medicine, but in others, agricultural exposure or poor water quality\u2014such as high silica or hardness\u2014were suspected causes,\u201d she said.<\/p>\n

\u201cCKDu is not unique to Telangana. It\u2019s been reported from many parts of the world and also from regions in India like Goa and Puducherry. A lot of research is going on to understand what causes it. Some researchers believe it\u2019s linked to water contamination, others to dehydration, infections, or the use of unlicensed traditional medicines. People are now studying genetic factors as well. You can find thousands of papers online on CKDu\u2014everyone is trying to understand why it happens,\u201d she said.<\/p>\n

Seventy-seven per cent of patients drank groundwater from borewells or municipal supplies. The remaining 22.7 percent relied on surface water from streams and lakes.<\/p>\n

Researchers sent samples to the Institute of Preventive Medicine, Narayanaguda, for analysis. Tests measured heavy metals, toxins, hardness, and electrical conductivity. The results came back acceptable.<\/p>\n

This contradicted findings from Sri Lanka, where studies had linked CKDu to high fluoride levels, increased water hardness, and elevated electrical conductivity. In one Sri Lankan study, fluoride levels ranged from 0.28 to 6.8 mg\/L in affected areas versus 0.02 to 0.70 mg\/L in control regions.<\/p>\n

\u201cOur study showed that alternative medicine use may be causal,\u201d the authors emphasised in their paper, noting this differed from the Sri Lankan experience, where only 1.2-3% of patients had used ayurvedic medicines.<\/p>\n

The Telangana water analysis occurred at a single time point due to logistical constraints, the researchers acknowledged. Seasonal variations or historical contamination remained unexplored.<\/p>\n

Also Read: How microbiome health impacts kidney in diabetes<\/a>
\nWho developed kidney disease?<\/p>\n

The average age of the patients was 41. Two-thirds were men. One quarter had never received a formal education.<\/p>\n

They worked various jobs\u2014not just agriculture. Some were in construction, others ran small businesses, and many held service positions. The disease crossed occupational boundaries.<\/p>\n

\u201cThe main finding of the study is that patients with CKD who satisfy the CKDu phenotype as defined from the \u2018hot spots\u2019 are not uncommon elsewhere, and not limited to those with traditional risk factors such as agriculture,\u201d the authors stated in their paper.<\/p>\n

Thirty-seven percent consumed alcohol. Twenty-four per cent used tobacco. These rates exceeded those reported in studies from Tamil Nadu, where Parameswaran and colleagues documented lower substance use among CKDu patients.<\/p>\n

Twenty-three percent reported excessive analgesic use in preceding years. Eight percent had hypothyroidism.<\/p>\n

Most patients\u201469 percent\u2014produced normal urine volumes when they first presented. Twenty-eight percent experienced nocturia, waking multiple times to urinate. Seventy-seven per cent complained of fatigue. Only 13.3 percent had developed swelling.<\/p>\n

These subtle symptoms masked severe disease. Forty percent had already reached stage 5 CKD at presentation. Nine percent required immediate dialysis.<\/p>\n

Also Read:\u00a0How cooking smoke is silently damaging ageing minds<\/a>
\nSpeed of kidneys\u2019 decline<\/p>\n

Researchers tracked kidney function at baseline, six months, and 12 months. They excluded patients who died or needed maintenance haemodialysis, and then categorised the remainder as fast or slow progressors.<\/p>\n

Fast progressors lost at least 4 mL\/min\/1.73 m\u00b2 of kidney filtering capacity per year \u2014a measurement showing how many millilitres of blood the kidneys can clean per minute, adjusted for body surface area. Twenty-eight patients fell into this category: 75 percent were men, 28.6 percent had agricultural backgrounds, and 42.9 percent had developed hypertension.<\/p>\n

Twenty patients progressed slowly, losing less than 4 mL\/min\/1.73 m\u00b2 annually. Sixty-five percent were men.<\/p>\n

Overall, 26 patients reached end-stage kidney disease within the study period. Of these, 80.8 percent had consumed groundwater, 42.3 percent used alcohol significantly, 26.9 percent smoked, and 53.8 percent had developed hypertension during their illness.<\/p>\n

Hypertension posed a puzzle. Traditional CKDu definitions exclude patients with high blood pressure, assuming it causes rather than results from kidney disease. But biopsies from Telangana patients with mild hypertension showed chronic interstitial nephritis without changes typical of hypertensive kidney damage.<\/p>\n

\u201cThus, mild hypertension\/short duration hypertension should not be an exclusion criterion for CKDu, and if feasible, biopsy should be done to establish etiology in such cases,\u201d the authors argued in their paper.<\/p>\n

The limitations of small studies<\/p>\n

Dr Sahay acknowledged the constraints of single-centre research.<\/p>\n

\u201cAlternative medicine use is common in our society, but we as nephrologists only see those patients who come to us after kidney failure has already occurred. Not every kidney failure patient has taken alternative medicine, and not everyone taking it will necessarily develop kidney disease,\u201d Dr Sahay said.<\/p>\n

\u201cTo understand the actual prevalence or cause, effect-relationship, we need larger epidemiological studies\u2014that\u2019s where public health or community medicine experts can help. They see patients with various complications, whether it\u2019s liver, kidney, or something else, and can track broader patterns. Our study is small, based only on the patients who came to Osmania Hospital. Similar studies from Andhra Pradesh, Goa, and Puducherry have also shown different risk factors\u2014sometimes it\u2019s heat stress, sometimes water quality, sometimes herbal remedies,\u201d she said.<\/p>\n

The study operated from a single centre, limiting its geographical scope. Researchers used the Indian consensus definition of CKDu, which includes patients with up to 2 grammes of protein in urine and mild hypertension\u2014broader criteria than other international definitions.<\/p>\n

Some patients had kidneys too small and scarred for safe biopsy. Without tissue samples, doctors could not rule out other causes definitively.<\/p>\n

The late presentation complicated the diagnosis. By the time symptoms drove patients to the hospital, damage had accumulated for years. Earlier stages of the disease went undocumented.<\/p>\n

\u201cSome of these cases could be due to other causes that were missed because of late presentation,\u201d the researchers acknowledged in their paper.<\/p>\n

Also Read: Tips to prevent, detect and treat kidney disease<\/a>
\nThe path to answers<\/p>\n

Dr Sahay explained how the scientific community will piece together the puzzle.<\/p>\n

\u201cAfter all this research from different parts of the world is published, scientists will conduct meta-analyses combining results from many smaller studies to identify common factors. That\u2019s how discoveries are made. Each group publishes its findings, and when all that data is analysed together, we can begin to see what\u2019s really responsible for CKDu,\u201d she said.<\/p>\n

\u201cRight now, genetic studies are also underway, but the results haven\u2019t been published yet because the work is still ongoing. It will take some time before we have clear answers. Each research group is reporting what they are observing in their own population\u2014what we found in Telangana is what we have documented. That\u2019s why publishing every study, no matter how small, is important. It helps researchers across India and the world compare patterns\u2014whether the cause lies in unlicensed alternative medicine, genetics, or something else. Over time, when enough studies are collected, meta-analyses and statistical tools will help pinpoint the leading cause,\u201d she said.<\/p>\n

The authors called for an expanded investigation: \u201cThere is a need for long-term multicentric studies utilising demographic data, biochemical parameters, proteomics, metabolomics, and genomics and biopsy studies to determine the exact cause of CKDu.\u201d<\/p>\n

They emphasised that future biopsies should include electron microscopy, following recommendations from the International Society of Nephrology\u2019s consortium on CKDu.<\/p>\n

Meanwhile,\u00a0\u00a0Dr Sahay offered clear guidance.<\/p>\n

\u201cSo the picture is multifactorial. Research is still ongoing to understand whether it\u2019s genetics, environment, or both. What we can say for sure is that people must avoid unlicensed or unsupervised medicines. Even if they\u2019re from an AYUSH system, the practitioner must be registered and the medicine prescribed. Taking unknown powders, bhasmas, or liquids recommended by friends or relatives without medical supervision is unsafe. We should always know what we\u2019re taking and do it under expert guidance,\u201d she recommended.<\/p>\n

(Edited by Majnu Babu).<\/p>\n

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