410 High Prevalence, Low Awareness and Poor Control of Hypertension in the Community Setting: Lessons from the Kidney Disease Screening and Awareness Program (KDSAP)

Abstract Background Those living with kidney disease (KD) report extensive symptom burden. However, research into how symptoms change across stages is limited. The aims of this study were to 1) describe symptom burden across disease trajectory, and 2) to explore whether symptom burden is unique to KD when compared to a non-KD population. Methods Participants aged > 18 years with a known diagnosis of KD (including haemodialysis (HD) and peritoneal dialysis (PD)) and with a kidney transplant) completed the Leicester Kidney Symptom Questionnaire (KSQ). A non-KD group was recruited as a comparative group. Multinominal logistic regression modelling was used to test the difference in likelihood of those with KD reporting each symptom. Results In total, 2279 participants were included in the final analysis (age 56.0 (17.8) years, 48% male). The main findings can be summarised as: 1) the number of symptoms increases as KD severity progresses; 2) those with early stage KD have a comparable number of symptoms to those without KD; 3) apart from those receiving PD, the most frequently reported symptom across every other group, including the non-KD group, was ‘feeling tired’; and 4) being female independently increased the likelihood of reporting more symptoms. Conclusions Our findings have important implications for patients with KD. We have shown that high symptom burden is prevalent across the spectrum of disease, and present novel data on symptoms experienced in those without KD. Symptoms requiring the most immediate attention given their high prevalence may include pain and fatigue. Trial registration The study was registered prospectively as ISRCTN11596292.

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The influence of water–rock interactions on household well water in an area of high prevalence chronic kidney disease of unknown aetiology (CKDu)

npj Clean Water ◽

10.1038/s41545-020-00092-0 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Liza K. McDonough ◽

Karina T. Meredith ◽

Chandima Nikagolla ◽

Richard B. Banati

Keyword(s):

Water Quality ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Water Chemistry ◽

Mass Balance ◽

Stable Carbon Isotopes ◽

Environmental Isotopes ◽

Well Water ◽

High Prevalence ◽

Geochemical Mass Balance

AbstractPoor drinking water quality in household wells is hypothesised as being a potential contributor to the high prevalence of chronic kidney disease of uncertain aetiology (CKDu) among the farming communities of the Medawachchiya area, Anuradhapura, Sri Lanka. One of the natural processes that can affect water quality is the dissolution of minerals contained within an aquifer by water–rock interactions (WRIs). Here we present a comprehensive assessment of WRIs and their influence on the water chemistry in household wells and spring waters in the Medawachchiya area by combining measurements of environmental isotopes, such as strontium, lithium and stable carbon isotopes and inorganic chemistry parameters, and modelling geochemical mass balance reactions between rainfall and groundwater samples. Our results reveal the presence of strontium, dissolved from both silicate and carbonate minerals, with high isotopic (87Sr/86Sr) ratios of up to 0.7316. Geochemical mass balance modelling and prior 87Sr/86Sr studies on the Wanni Complex bedrock suggest these strontium values may be the result of biotite dissolution. We also identify lithium and uranium contributed from the dissolution of silicates, albeit at concentrations too low to constitute a known health risk. In contrast, the levels of magnesium and calcium in our samples are high and demonstrate that, despite the felsic bedrock, well water chemistry in the Medawachchiya area is dominated by carbonate dissolution.

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