Structural violence and chronic kidney disease of unknown etiology in Sri Lanka

Background: The significant increase in the burden of chronic kidney disease of unknown etiology (CKDu) of Sri Lanka has led to evaluate the factors related to physical, social and mental aspects of health-related quality of life (HRQOL) in CKDu patients. Methods: The quality of life of 84 CKDu patients (stages 1-5) were assessed by means of the Kidney Disease Quality of Life Short-Form survey (KDQOL™-36) Version 1.3 along with biomarkers and patient demographics. The estimated glomerular filtration rate (eGFR) was calculated using the Modification of Diet in Renal Disease (MDRD) formula. Results: KDQOL™-36 scores impaired substantially across all stages of CKDu and comparatively lower scores were present in later stages of the disease than the initial stages. The mental composite summary (MCS) scores were more impaired when compared to physical composite summary (PCS) scores during the early stage of the disease. Poor KDQOL™-36 scores were present in males than in females with a significant difference in MCS and social support scales. Biochemical parameters showed a significant correlation with the majority of KDQOL™-36 dimensions while urine albumin to creatinine ratio did not. Conclusion: CKDu patients in any stage of the disease despite their age and gender have a significant physical and mental health burden. Thereby, early assessment of health-related quality of life will help to identify high-risk patients, and modifying these factors may provide a better active and healthy lifestyle.

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Evaluation of groundwater quality and reverse osmosis water treatment plants in the endemic areas of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka

The Science of The Total Environment ◽

10.1016/j.scitotenv.2020.140716 ◽

2020 ◽

Vol 745 ◽

pp. 140716

Author(s):

Sachithra Imbulana ◽

Kumiko Oguma ◽

Satoshi Takizawa

Keyword(s):

Chronic Kidney Disease ◽

Water Treatment ◽

Sri Lanka ◽

Kidney Disease ◽

Groundwater Quality ◽

Reverse Osmosis ◽

Unknown Etiology ◽

Water Treatment Plants ◽

Endemic Areas

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Upregulation of Oxidative Stress Related Genes in a Chronic Kidney Disease Attributed to Specific Geographical Locations of Sri Lanka

BioMed Research International ◽

10.1155/2016/7546265 ◽

2016 ◽

Vol 2016 ◽

pp. 1-9 ◽

Cited By ~ 7

Author(s):

Saravanabavan Sayanthooran ◽

Dhammika N. Magana-Arachchi ◽

Lishanthe Gunerathne ◽

Tilak D. J. Abeysekera ◽

Suneth S. Sooriyapathirana

Keyword(s):

Oxidative Stress ◽

Chronic Kidney Disease ◽

Sri Lanka ◽

Kidney Disease ◽

Quantitative Polymerase Chain Reaction ◽

Fibroblast Growth Factor 23 ◽

Study Groups ◽

Unknown Etiology ◽

Pyrin Domain ◽

Expression Of Genes

Objective.To infer the influence of internal and external oxidative stress in chronic kidney disease patients of unknown etiology (CKDu) in Sri Lanka, by analyzing expression of genes related directly or indirectly to oxidative stress: glutamate-cysteine ligase catalytic subunit (GCLC), glutathione S-transferase mu 1 (GSTM1), glucose-6-phosphate dehydrogenase (G6PD), fibroblast growth factor-23 (FGF23), and NLR family pyrin domain containing 3 (NLRP3).Methods.Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was carried out for the selected populations: CKDu patients (n=43), chronic kidney disease patients (CKD;n=14), healthy individuals from a CKDu endemic area (GHI;n=9), and nonendemic area (KHI;n=16). Fold changes were quantified relative to KHI.Results.GCLC had greater than threefold upregulation in all three study groups, with a maximum of 7.27-fold upregulation in GHI (p=0.000). GSTM1 was not expressed in 25.6% of CKDu and 42.9% of CKD patients, but CKDu patients expressing GSTM1 showed upregulation of 2.60-fold (p<0.05). Upregulation of FGF23 and NLRP3 genes in CKD and CKDu was observed (p<0.01), with greater fold changes in CKD.Conclusion.Results suggest higher influence of external sources of oxidative stress in CKDu, possibly owing to environmental conditions.

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Glyphosate, Hard Water and Nephrotoxic Metals: Are They the Culprits Behind the Epidemic of Chronic Kidney Disease of Unknown Etiology in Sri Lanka?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph110202125 ◽

2014 ◽

Vol 11 (2) ◽

pp. 2125-2147 ◽

Cited By ~ 131

Author(s):

Channa Jayasumana ◽

Sarath Gunatilake ◽

Priyantha Senanayake

Keyword(s):

Chronic Kidney Disease ◽

Sri Lanka ◽

Kidney Disease ◽

Hard Water ◽

Unknown Etiology

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Endemic chronic kidney disease of unknown etiology in Sri Lanka: Correlation of pathology with clinical stages

Indian Journal of Nephrology ◽

10.4103/0971-4065.145095 ◽

2015 ◽

Vol 25 (5) ◽

pp. 274 ◽

Cited By ~ 18

Author(s):

S Wijetunge ◽

N. V. I. Ratnatunga ◽

T. D. J. Abeysekera ◽

A. W. M. Wazil ◽

M Selvarajah

Keyword(s):

Chronic Kidney Disease ◽

Sri Lanka ◽

Kidney Disease ◽

Unknown Etiology ◽

Clinical Stages

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Identification of Novel Rodent-Borne Orthohantaviruses in an Endemic Area of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka

Viruses ◽

10.3390/v13101984 ◽

2021 ◽

Vol 13 (10) ◽

pp. 1984

Author(s):

Devinda S. Muthusinghe ◽

Kenta Shimizu ◽

Sithumini M. W. Lokupathirage ◽

Zhouoxing Wei ◽

Yomani D. Sarathkumara ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Sri Lanka ◽

Kidney Disease ◽

Small Mammals ◽

Endemic Area ◽

Phylogenetic Analyses ◽

Rattus Rattus ◽

Genetic Evidence ◽

Unknown Etiology ◽

Sri Lankan

We reported the genetic evidence of circulating hantaviruses from small mammals captured in a chronic kidney disease of unknown etiology (CKDu) hotspot area of Sri Lanka. The high seroprevalence of anti-hantavirus antibodies against Thailand orthohantavirus (THAIV) has been reported among CKDu patients and rodents in Sri Lankan CKDu hotspots. We captured 116 small mammals from CKDu endemic regions in the Polonnaruwa District of Sri Lanka. Seven animals (five out of 11 Mus booduga and two out of 99 Rattus rattus) were PCR-positive for the hantavirus. A rat-borne sequence was grouped with a THAIV-like Anjozorobe virus. In contrast, Mus-borne sequences belonged to the THAIV lineage, suggesting a novel orthohantavirus species according to the phylogenetic analyses and whole-genome comparisons. Our genetic evidence indicates the presence of two THAIV-related viruses circulating in this CKDu endemic area, suggesting a basis for further investigations to identify the infectious virus in patients with CKDu and the CKDu induction mechanism of these viruses.

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