Diminished disease progression rate in a chronic kidney disease population following the replacement of dietary water source with quality drinking water: A pilot study

Nephrology ◽  
2018 ◽  
Vol 23 (5) ◽  
pp. 430-437
Author(s):  
Edirisinghe Arachchige Ranga Irosha Siriwardhana ◽  
Ponnamperuma Aratchige Jayasumana Perera ◽  
Ramiah Sivakanesan ◽  
Tilak Abeysekara ◽  
Danaseela Bandara Nugegoda ◽  
...  
2020 ◽  
Vol 10 (3) ◽  
pp. 539-548
Author(s):  
V. M. Jayasooriya ◽  
V. M. M. Perera ◽  
S. Muthukumaran

Abstract Chronic Kidney Disease of uncertain etiology (CKDu) is a fatal disease that causes death from kidney failure due to unknown risk factors and has already affected more than 400,000 people in the rural agricultural landscape (dry zone) of Sri Lanka. The major drinking source in Sri Lanka is groundwater and it is suspected that the pollution of groundwater sources due to agricultural means has a major impact on CKDu. The primary objective of this study is to determine whether rainwater can be used as an alternative safe drinking water source in Girandurukotte area, Sri Lanka, which is known to be an area endemic for CKDu. The physical, chemical, and biological analyses were performed to compare the water quality parameters of three water sources (groundwater, surface water, and rainwater) for Girandurukotte area. The most common storage tanks in polyethylene (PE) and ferrocement (FC) were compared to assess the influence of the material of rainwater tank on water quality. The results showed that there is a significant difference in rainwater in terms of water quality compared to groundwater and surface water. Rainwater in FC and PE tanks showed significant differences (p < 0.05) for some parameters however, they were still within accepted potable drinking water standards.


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Penny Vlahos ◽  
Stephen L. Schensul ◽  
Shuchi Anand ◽  
Emma Shipley ◽  
Saranga Diyabalanage ◽  
...  

AbstractA chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prevalence across dry lowland agricultural communities globally. Here we present the results of a prospective cohort of 293 patients with CKDu in the endemic region of Wilgamuwa, Sri Lanka, in whom we measured baseline kidney function and undertook quarterly follow up over 2 years. Well water was the primary historic drinking water source in the region, although a majority (68%) of participants reported switching to reverse osmosis water during study follow ups. Participants who reported ever drinking from well water had estimated glomerular filtration rates −6.7 (SD: 2.8) ml/min/1.73 m2 lower than participants who did not drink from well water historically (p = 0.0184) during the study period. Geospatial analysis identifies a cluster within the region where CKDu progression is significantly higher than the surrounding area. Samples of household wells (n = 262) indicated 68% had detectable agrochemical compounds with concentration above global water quality standards. It is expected that the detected contaminants compounds are indicators of poor water quality and that there is likely additional agrochemical exposure including commercial additives that may contribute to CKDu onset and/or progression. Thus, our study finds that well water exposure during a person’s lifetime in this region is associated with kidney function decline and identifies and quantifies putative nephrotoxic agrochemicals above safe drinking water concentrations in these wells.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Angela Rivera ◽  
Angelito Bernardo ◽  
Jasmin Vesga ◽  
Izcay Ronderos ◽  
Mauricio Sanabria

Abstract Background and Aims Chronic kidney disease (CKD) is a syndrome that today has important implications for the health of populations and the economic sustainability of health systems around the world, therefore strategies to slow disease progression are necessary. Aims: To estimate the incidence of renal replacement therapy (RRT) in a cohort of patients included in a CKD secondary prevention program and to describe the decrease of the estimated glomerular filtration rate (eGFR). Method This is a historical, multicenter, observational cohort study in a prevention program between January 1, 2010, and December 31, 2017, with follow-up until December 31, 2018, at the Renal Care Services (RCS) network. Socio-demographic and clinical characteristics of all patients were summarized descriptively. We estimated the incidence of RRT rate with Kaplan Meier analysis. Progression rate to RRT was analyzed by mixed-effects model adjusted for the eGFR reduction rate at 180 days; the model considered the diagnosis of diabetes. Results 7131 patients met the inclusion criteria for data analysis. The mean age was 65 years, 50.5% were female, (Table 1). There were 577 events of RRT with a rate of 2.02 events of RRT per 100 patients-year [95% CI,1.86 to 2.19], characteristics at the RRT initiation are presented in Table 2. At the beginning of the program the eGFR was 45.3 ml / min / 1.73m2 in non-diabetics, and 40.9 3 ml / min / 1.73m2 in diabetics. The CKD progression was - 0.48 ml / min / 1.73m2 per 180 days in diabetics and - 0.20 ml / min / 1.73m2 per 180 days in non-diabetics. The final events of the cohort are presented in Figure 1; the mortality rate was 0.89 events per 100 patients-year [95% CI, 0,79 to 1,01]. Conclusion This population of patients in a CKD prevention program presented a low rate of initiation of dialysis therapy and a slight decrease of eGFR; the diabetic status influences the CKD progression.


2021 ◽  
Vol 41 (1) ◽  
pp. 33-41
Author(s):  
Min Zhuo ◽  
Laura K. Triantafylidis ◽  
Jiahua Li ◽  
Julie M. Paik

2020 ◽  
Author(s):  
Csaba P Kovesdy ◽  
Danielle Isaman ◽  
Natalia Petruski-Ivleva ◽  
Linda Fried ◽  
Michael Blankenburg ◽  
...  

Abstract Background Chronic kidney disease (CKD), one of the most common complications of type 2 diabetes (T2D), is associated with poor health outcomes and high healthcare expenditures. As the CKD population increases, a better understanding of the prevalence and progression of CKD is critical. However, few contemporary studies have explored the progression of CKD relative to its onset in T2D patients using established markers derived from real-world care settings. Methods This retrospective, population-based cohort study assessed CKD progression among adults with T2D and with newly recognized CKD identified from US administrative claims data between 1 January 2008 and 30 September 2018. Included were patients with T2D and laboratory evidence of CKD as indicated by the established estimated glomerular filtration rate (eGFR) and urine albumin:creatinine ratio (UACR) criteria. Disease progression was described as transitions across the eGFR- and UACR-based stages. Results A total of 65 731 and 23 035 patients with T2D contributed to the analysis of eGFR- and UACR-based CKD stage progression, respectively. CKD worsening was observed in approximately 10–17% of patients over a median follow-up of 2 years. Approximately one-third of patients experienced an increase in eGFR values or a decrease in UACR values during follow-up. Conclusions A relatively high proportion of patients were observed with disease progression over a short period of time, highlighting the need for better identification of patients at risk of rapidly progressive CKD. Future studies are needed to determine the clinical characteristics of these patients to inform earlier diagnostic and therapeutic interventions aimed at slowing disease progression.


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