“Nearly one in 10 people in high income countries show signs of CKD, which is permanent kidney damage and loss of renal function,” Dr Osborne said. Risk factors of developing CKD include age, hypertension and diabetes. Dr Osborne said CKD with no known cause was rising in low-to-middle income countries such as India, Sri Lanka and Mesoamerica. “Initially, it was suspected the condition was associated with agricultural workplaces through exposure to heat stress, dehydration, pesticide spraying, heavy metals and agrochemicals,” Dr Osborne said. “However, environmental contamination, pesticide residues and herbal medicines potentially containing heavy metals may also be contributing to CKD.”