The need to revisit ochratoxin A risk in light of diabetes, obesity, and chronic kidney disease prevalence.

Ochratoxin A (OTA) is a mycotoxin, or fungal toxin, that contaminates multiple foodstuffs worldwide. Affected commodities include oats, wheat, maize, barley, raisins and other dried vine fruits, wine, beer, coffee, and cocoa. Although OTA has been shown to cause kidney disease, including kidney cancer, in multiple animal species, the impact of dietary OTA on human health from a global perspective has been less clear. Several epidemiological studies suggest an association between OTA exposure and human kidney disease, but evidence of causality has been limited. Nonetheless, because OTA is common in so many foodstuffs and may play a role in kidney disease, we consider it important to improve the body of evidence surrounding OTA's adverse effects to humans, as well as human dietary exposures in different parts of the world. This is especially true in the light of increasing type 2 diabetes and obesity prevalence worldwide; both conditions frequently lead to chronic kidney disease (CKD), and may synergize with dietary OTA exposure to increase CKD risk.