Environmental Factors Incriminated in the Development of End Stage Renal Disease in El-Minia Governorate, Upper Egypt

End Stage Renal Disease (ESRD) has various causes that differ according topatient''s country. In Egypt it is a huge health problem with high prevalence in El-Minia governorate as 308per million population suffer from it. The aim of the work is to investigate the possible causes of ESRD with an unknown etiology in El-Minia Governorate.. A total number of 216 patients with an unknown etiology of ESRD as well as 220 controls were interviewed using a structured questionnaire including information about environmental factors predicted to cause ESRD such as occupation, pesticide handling, and source of drinking water.. Distribution of patients by residence showed that most patients lived in rural areas (76%), comparedto 57% in controls (p<0.001). Drinking unsafe water was reported by 72% of patients and 48% of controls (p<0.001). Family history of renal disease was found among 10% of patients and 4% of controls (p<0.001). Exposure to pesticides and using herbs for the treatment were more among patients than controls (52% Vs 14% respectively) and (34% Vs 6% respectively) (p<0.001).. ESRD with an unknown etiology may be attributed to environmental factors suhc as drinking unsafe water, exposure to pesticides and using herbs for treatment. Educational programs for common people should be strengthened. Lead pipes water supplies should be changed. Use of any herbs should be prohibited except under the supervision of Ministry of Health..