Emergence of new CKDu hotspots in rural areas of India: a comprehensive overview of environmental, socio-legal and health implications

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Anjali Vijayan
Neena Elezebeth Philip
Lekha D Bhat
Bhagyalakshmi R

Abstract

Chronic Kidney Disease of Unknown Etiology (CKDu) emerges as a public health concern, particularly in low- and middle-income countries. Recent studies indicate a considerable rise in CKDu cases and the emergence of new hotspots in rural India, where minimal healthcare access and poor working conditions exacerbate vulnerability. Higher prevalence of Chronic Kidney Disease without attributing a cause, mostly prevalent in Southern India. Cases are predominantly reported from Telengana, Andra Pradesh, Tamil Nadu, Goa, Odisha, Punjab and Chattisgarh. In India, the disparity in healthcare infrastructure, particularly for dialysis and transplantation, along with social stigma, hampers effective management and early detection. Addressing CKDu demands an integrated approach from environmental, legal, public health and policy framework for ensuring enhanced water quality assessments.  Early diagnostic measures, engaging multidisciplinary research and drawing lessons from global experiences to formulate evidence-based interventions is pivotal.

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Author Biographies

Anjali Vijayan, Department of Geology, Central University of Tamil Nadu, Thiruvarur 610005, India

She is an Assistant Professor in the Department of Geology at the Central University of Tamil Nadu, India. She previously worked as a Research Associate at the National Centre for Earth Science Studies, Ministry of Earth Sciences, Government of India. Her current research focuses on medical geology and geochemistry. She has published in international journals on igneous petrology, geochemistry, geochronology, and medical geology.

Neena Elezebeth Philip, Department of Epidemiology and Public Health, Central University of Tamil Nadu, Thiruvarur 610005, India

She is an Assistant Professor in the Department of Epidemiology and Public Health at the Central University of Tamil Nadu. She is a research fellow with WHO-SEARO and holds a PhD from the Achutha Menon Centre for Health Sciences Studies at the Sree Chitra Tirunal Institute for Medical Sciences and Technology. She completed her MPH internship at Bielefeld University, Germany, with support from a DAAD (German Academic Exchange Service) scholarship. She was an INSPIRE Fellow under India’s Department of Science and Technology. Her publications include five book chapters and twenty research articles in international journals.

Lekha D Bhat, Department of Geology, Central University of Tamil Nadu, Thiruvarur 610005, India

She is an Assistant Professor in the Department of Epidemiology and Public Health at the Central University of Tamil Nadu. Her research interests include informal-sector health, adolescent health, social epidemiology, and qualitative research methods. She has published widely in peer-reviewed journals, including those published by Elsevier, Springer Nature, SAGE, Taylor & Francis, Wiley, and MDPI. She is a member of the editorial team of BMC Public Health and regularly appears as a public health expert on Sansad TV and BBC World News, discussing issues in the Indian context.

Bhagyalakshmi R, Department of Law, Central University of Tamil Nadu, Thiruvarur 610005, India

She is an Assistant Professor in the Department of Law at the Central University of Tamil Nadu. Her research interests span corporate and commercial law, regulatory theory, and the relationship between law and development. She is a recipient of the University Grants Commission’s Junior Research Fellowship and a life-member travel bursary from the Society of Corporate Law Academics, Australia. She has published widely in Scopus-indexed journals, contributed book chapters on public–private partnerships and Indigenous rights, and presented papers at prominent national and international conferences, including at the University of Oxford.

How to Cite

Vijayan, A., Elezebeth Philip, N., Bhat, L. D., & R, B. (2026). Emergence of new CKDu hotspots in rural areas of India: a comprehensive overview of environmental, socio-legal and health implications. JOURNAL OF GEOETHICS AND SOCIAL GEOSCIENCES, 1(2), 1-9. https://doi.org/10.4401/jgsg-126

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