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

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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Significance of Mg-hardness and fluoride in drinking water on chronic kidney disease of unknown etiology in Monaragala, Sri Lanka

Environmental Research ◽

10.1016/j.envres.2021.111779 ◽

2021 ◽

pp. 111779

Author(s):

D.N.D. Liyanage ◽

Saranga Diyabalanage ◽

S.P. Dunuweera ◽

Sanath Rajapakse ◽

R.M.G. Rajapakse ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Drinking Water ◽

Sri Lanka ◽

Kidney Disease ◽

Unknown Etiology

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Anthropometric changes in chronic kidney disease of unknown etiology (CKDU) patients: a single-center longitudinal study in Sri Lanka

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2021.09.421 ◽

2021 ◽

Vol 46 ◽

pp. S692

Author(s):

H.M. Abeywickrama ◽

Y. Koyama ◽

S. Wimalasiri ◽

M. Uchiyama ◽

U. Shimizu ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Longitudinal Study ◽

Sri Lanka ◽

Kidney Disease ◽

Unknown Etiology ◽

Single Center

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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

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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.

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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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Association of Hantavirus Infections and Leptospirosis With the Occurrence of Chronic Kidney Disease of Uncertain Etiology in the North Central Province of Sri Lanka: A Prospective Study With Patients and Healthy Persons

Frontiers in Cellular and Infection Microbiology ◽

10.3389/fcimb.2020.556737 ◽

2020 ◽

Vol 10 ◽

Author(s):

N. P. Sunil-Chandra ◽

J. A. A. S. Jayaweera ◽

W. Kumbukgolla ◽

M. V. M. L. Jayasundara

Keyword(s):

Chronic Kidney Disease ◽

Sri Lanka ◽

Kidney Disease ◽

Significant Risk ◽

Study Groups ◽

Hantavirus Infection ◽

Strain Specificity ◽

Climate Conditions ◽

Significant Difference ◽

Uncertain Etiology

Chronic Kidney disease of uncertain etiology (CKDu) has become a significant disease burden, affecting farming community of Sri Lanka and the exact etiology, which could be multifactorial, is not hitherto established. This study is aimed to determine the association of past hantavirus infection and leptospirosis with the occurrence of CKDu. A cohort (n = 179) of known CKDu patients living in high-CKDu prevalent areas of Anuradhapura district of Sri Lanka was compared with a group of 49 healthy, sex-matched younger blood relatives of CKDu patients (control-1) and another 48 healthy, age, and sex-matched individuals living in low-CKDu prevalent area (control-2) of the same district where same life style and climate conditions prevail. Fifty out of 179 (27.9%) CKDu patients, 16/49 (32.7%) of control-1 and 7/48 (14.6%) of control-2 were found positive for IgG antibodies to Puumala, Hantaan or both strains of hantaviruses. Hantaan strain specificity was found to be predominant in all study groups. Hantavirus IgG sero-prevalence of healthy individuals living in low-CKDu prevalent area was significantly lower compared to CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas (p = 0.03). Past hantavirus infection possesses a significant risk for the occurrence of CKDu (OR = 4.5; 95% CI-3.1-5.4, p = 0.02). In contrast, IgG seroprevalence to hantaviruses was not significantly different in CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas indicating past hantavirus infection has no association with the occurrence of CKDu or possibly, younger relatives may develop CKDu in subsequent years. Seroprevalence to leptospirosis showed no significant difference between CKDu patients and healthy controls.

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Effect of Different Stages of Chronic Kidney Disease and Renal Replacement Therapies on Oxidant-Antioxidant Balance in Uremic Patients

Biochemistry Research International ◽

10.1155/2013/358985 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 31

Author(s):

Hadja Fatima Tbahriti ◽

Abbou Kaddous ◽

Malika Bouchenak ◽

Khedidja Mekki

Keyword(s):

Oxidative Stress ◽

Chronic Kidney Disease ◽

Antioxidant Enzymes ◽

Vitamin E ◽

Kidney Disease ◽

Thiobarbituric Acid ◽

Study Groups ◽

Cardiovascular Complications ◽

Protein Carbonyls ◽

Severe Stage

Oxidative stress seems to be involved in the path physiology of cardiovascular complications of chronic kidney disease (CKD). In this study, we determined the effect of different stages of CKD and substitutive therapies on oxidative stress. One hundred sixty-seven patients (age:44±06years; male/female: 76/91) with CKD were divided into 6 groups according to the National Kidney Foundation classification. Prooxidant status was assessed by assaying thiobarbituric acid reactive substances, hydroperoxides, and protein carbonyls. Antioxidant defence was performed by analysis of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, vitamin E, Iron, and bilirubin. TBARS and LPO were higher in HD patients compared to other groups (P<0.001), while protein carbonyls were more increased in PD patients. The antioxidant enzymes were declined already at severe stage of CKD and they were declined notably in HD patients (P<0.001). Similar observation was found for vitamin E, Fe, and bilirubin where we observed a significant decrease in the majority of study groups, especially in HD patients (P<0.001). The evolution of CKD was associated with elevated OS. HD accentuates lipid, while PD aggravates protein oxidation. However, the activity of antioxidant enzymes was altered by impaired renal function and by both dialysis treatments.

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