Among Farmers in Sri Lanka, Kidney Disease on the Rise

In several regions of the dry zone of Sri Lanka, excessive quantities of fluoride (F-) in groundwater have affected the water quality significantly. Apart from the well-known prevalence of dental fluorosis, Chronic Kidney Disease of uncertain etiology (CKDu) is widespread in different pockets in the dry zone of Sri Lanka [1]. Fluoride is one of the substances suspected of being causative of CKDu in the area. Since the kidneys retain more F- than in any other soft tissue and excess F- exposure can cause kidney disease. Within the same zone, the prevalence of CKDu varies by geographic area in a ground water and spatial distribution of selected trace elements in groundwater. The optimum F- level in drinking water, according to WHO guidelines, is 1.5 (mg/L); however, due to the unfavorable climatic conditions that exist in tropical countries, people ingest more water than normal intake, resulting in a high F- intake. The source of F- is geogenic. It has been found that the F- content of basement rocks ranges from 9.5×10-5 to 1.44×10-3 kg/L in the region [3]. Farmers consume about 2-3 liters of water a day to quench their thirst, resulting in a daily F- intake of 3×10-3-1×10-2 kg/L [4].

Download Full-text

Safe water for all: A nature-based approach for cyanotoxin elimination from potable water

Access Microbiology ◽

10.1099/acmi.ac2020.po0574 ◽

2020 ◽

Vol 2 (7A) ◽

Author(s):

Sylvia Soldatou ◽

Anjali Jaykumar ◽

Abeysiri H.A.S.N ◽

Pathmalal M. Manage ◽

Ondřej Mašek ◽

...

Keyword(s):

Sri Lanka ◽

Kidney Disease ◽

Crop Residues ◽

Clean Energy ◽

Cyanobacterial Blooms ◽

Sri Lankan ◽

High Concentration ◽

Safe Water ◽

Key Factor ◽

Coconut Shells

Cyanobacterial blooms are a serious threat to public health and water quality due to the production of cyanotoxins as a result of nutrient pollution from industry, agriculture, domestic waste as well as global warming. The microcystins (MCs) are the most abundant cyanotoxins consisting of >200 analogues causing both acute and chronic toxicity, sometimes resulting in death. In Asian countries, such as Sri Lanka, reports of kidney disease are constantly increasing. Although no direct link between metal and pesticide contamination in water and kidney disease has been found, high concentration of cyanobacteria cells in drinking water wells implies that the nephrotoxic effects of cyanotoxins might play a key factor in the reports of Chronic Kidney Disease of unknown aetiology (CKDu) in Sri Lanka. Therefore, we propose a nature-based approach for water treatment which will study the hypotheses that cyanotoxins can cause CKDu. Sri Lankan bacterial isolates (Alcaligens sp., Roseateles sp., Bacillus sp., and Micrococcus sp.) known to degrade microcystins, were used to form biofilm on biochar from Sri Lankan crop residues, such as coconut shells. The immobilisation of the microbes was assessed via a high-throughput colourimetric assay, followed by monitoring the biodegradation rate of microcystins when added to the immobilised cultures. Biodegradation products were analysed and identified through molecular networking and quantified via LC-MS/MS. Ultimately, this project will provide safe water in line with UN Sustainable Development Goal 6.1 as well contributing in sustainable goals 7 (Affordable and Clean Energy), 11 (Sustainable Cities and Communities) and 12 (Responsible Production and Consumption).

Download Full-text

Glyphosate and AMPA of agricultural soil, surface water, groundwater and sediments in areas prevalent with chronic kidney disease of unknown etiology, Sri Lanka

Journal of Environmental Science and Health Part B ◽

10.1080/03601234.2018.1480157 ◽

2018 ◽

Vol 53 (11) ◽

pp. 729-737 ◽

Cited By ~ 19

Author(s):

Shankani Gunarathna ◽

Buddhika Gunawardana ◽

Mahesh Jayaweera ◽

Jagath Manatunge ◽

Kasun Zoysa

Keyword(s):

Chronic Kidney Disease ◽

Surface Water ◽

Sri Lanka ◽

Kidney Disease ◽

Agricultural Soil ◽

Soil Surface ◽

Unknown Etiology

Download Full-text

Health-related Quality of Life among Patients with Chronic Kidney Disease of Unknown Etiology (CKDu) of an agricultural Community in Kebithigollawa, Sri Lanka

Journal of Clinical and Medical Research ◽

10.37191/mapsci-2582-4333-3(3)-071 ◽

2021 ◽

Author(s):

Nishantha Kumarasinghe

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Sri Lanka ◽

Kidney Disease ◽

Unknown Etiology ◽

Health Related Quality ◽

Early Assessment ◽

Related Quality ◽

Health Related

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.

Download Full-text

Quality of Life and Symptom Burden among Chronic Kidney Disease of Uncertain Etiology (CKDu) Patients in Girandurukotte, Sri Lanka

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17114041 ◽

2020 ◽

Vol 17 (11) ◽

pp. 4041 ◽

Cited By ~ 1

Author(s):

Hansani Madushika Abeywickrama ◽

Swarna Wimalasiri ◽

Yu Koyama ◽

Mieko Uchiyama ◽

Utako Shimizu ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Sri Lanka ◽

Kidney Disease ◽

Short Form ◽

Symptom Burden ◽

Symptom Index ◽

The Mean ◽

Uncertain Etiology

Symptom burden and health-related quality of life (HRQOL) are important predictors of how a disease affects patients’ lives, especially for endemic health problems such as chronic kidney disease of uncertain etiology (CKDu). Our study describes symptom burden, HRQOL, and associated demographic and clinical variables in CKDu patients in the Girandurukotte area, Sri Lanka. A cross-sectional study included 120 CKDu patients attending the renal clinic in the endemic area. The instruments applied were the Kidney Disease Quality of Life—Short Form (KDQOL-SFTM) version 1.3 and CKD Symptom Index—Sri Lanka. Socio-demographic, disease-related, and anthropometric variables were also investigated. The mean age of patients was 61.87 (SD 11.31), while 69.2% were male. The mean glomerular filtration rate was 28.17 (SD 14.03) mL/min/1.73 min2, and 70.8% were anemic. Bone/joint pain was the most experienced symptom while the median number of symptoms reported by patients was 5 (IQR 3–7). The mean symptom burden, physical component summary, mental component summary, and kidney-disease-specific component scores were 12.71 (SD 10.45), 68.63 (SD 19.58), 78.53 (SD 18.78), and 81.57 (SD 5.86), respectively. Age was found to be a significant predictor of HRQOL, while hemoglobin level and being a farmer were significant predictors of symptom burden. Our data indicate that CKDu patients in all stages experience at least one symptom affecting all aspects of HRQOL.

Download Full-text