scholarly journals Seasonal Variations in Groundwater Quality and Hydrogeochemistry in the Endemic Areas of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka

Water ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 3356
Author(s):  
Sachithra Imbulana ◽  
Kumiko Oguma ◽  
Satoshi Takizawa
Keyword(s):  
Chronic Kidney Disease ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Groundwater Quality ◽  
Seasonal Variations ◽  
High Hardness ◽  
Vital Role ◽  
Unknown Etiology ◽  
Simultaneous Occurrence ◽  
Endemic Areas

Groundwater quality and geochemical processes were investigated in the endemic areas of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka. Representative groundwater samples (n = 60) were collected from 30 dug wells located in the Anuradhapura district, over the dry and wet seasons. The samples were analyzed for pH, electrical conductivity (EC), total dissolved solids (TDS), alkalinity, major cations and major anions. Calcium-magnesium-bicarbonate ion combinations are predominant in this groundwater, and the simultaneous occurrence of high hardness (382–394 mg/L as CaCO3), alkalinity (364–379 mg/L as CaCO3) and ionicity is a salient characteristic. Alkalinity, TDS, hardness, and magnesium exceeded the safe limits for drinking in over half of the samples, regardless of the season. The major ion chemistry (Ca2+, Mg2+, Na+ and HCO3−) is primarily governed by the weathering of carbonate and silicate minerals, ion exchange, and evaporation which is accelerated by the semi-arid climate. Fluoride and chloride inputs are regulated by dissolution of fluoride-bearing minerals and anthropogenic causes, respectively. Saturation indices suggested supersaturation of carbonates and silicates, and undersaturation of evaporites and fluorite. Persistent high ionicity, and hardness of groundwater that is seldom impacted by seasonal variations might be playing a vital role in the genesis of CKDu.

scholarly journals Arsenic, cadmium, lead, and chromium in well water, rice, and human urine in Sri Lanka in relation to chronic kidney disease of unknown etiology

2018 ◽  
Vol 16 (2) ◽  
pp. 212-222 ◽  
Author(s):  
H. M. Ayala S. Herath ◽  
Tomonori Kawakami ◽  
Shiori Nagasawa ◽  
Yuka Serikawa ◽  
Ayuri Motoyama ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Human Urine ◽  
Urine Samples ◽  
Unknown Etiology ◽  
Well Water ◽  
Rice Samples ◽  
Endemic Areas ◽  
Cadmium Lead

Abstract Chronic kidney disease of unknown etiology (CKDu) is spreading gradually in Sri Lanka. In the current research, 1,435 well water samples from all 25 districts of Sri Lanka, 91 rice samples, and 84 human urine samples from both CKDu-endemic and non-endemic areas in Sri Lanka were analyzed for arsenic, cadmium, lead, and chromium to detect whether toxic elements could be a cause of CKDu. The liver-type fatty acid binding protein (L-FABP) concentration and arsenic, cadmium, lead, and chromium concentrations of the urine samples were analyzed to determine the relation of L-FABP with arsenic, cadmium, lead, and chromium. High concentrations of arsenic, cadmium, lead, and chromium were not detected in the well water samples from CKDu-endemic areas. Arsenic, cadmium, and lead contents in the rice samples from both CKDu-endemic and non-endemic areas were well below the Codex standard. There were no relationships between the L-FABP concentration and concentrations of arsenic, cadmium, lead, and chromium in urine. In addition, arsenic, cadmium, lead, and chromium concentrations in human urine samples from CKDu-endemic areas were not significantly different from those from non-endemic areas. These findings indicated that arsenic, cadmium, lead, and chromium could not cause CKDu.

scholarly journals Exploring the Root Cause for Chronic Kidney Disease of Unknown Etiology (CKDu) via Analysis of Metal Ion and Counterion Contaminants in Drinking Water: A Study in Sri Lanka

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
W. P. R. T. Perera ◽  
M. D. N. R. Dayananda ◽  
J. A. Liyanage
Keyword(s):  
Chronic Kidney Disease ◽  
Drinking Water ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Water Samples ◽  
Unknown Etiology ◽  
Reference Area ◽  
Permissible Limits ◽  
Dug Wells ◽  
Endemic Areas

The introduction of elevated amounts of foreign ions into the blood may lead to impairment of the filtration membrane of kidneys and chronic kidney damage. In order to assess the risk of consumption of drinking water (dug well water) in chronic kidney disease of unknown etiology (CKDu), affected areas in Sri Lanka, trace metals, and other counterions in water samples obtained from dug wells were analyzed and compared with a reference area. Drinking water could be the major source that is responsible for entering nephrotoxic ion contaminants into the human body. To achieve the objective, drinking water samples were collected from dug wells in two CKDu endemic areas and a reference area where no CKDu patients were found in a dry season. In the Wewelketiya area (one of the endemic areas), Cd concentrations in 60% of water samples and Pb concentrations in 40% of water samples have exceeded the maximum limit given by Sri Lanka water quality standards. Fluoride concentrations also have exceeded the permissible limits of more than 80% of collected water samples in both CKDu endemic areas. However, none of the water samples in reference areas has reported that Cd, Pb, and fluoride are beyond their maximum permissible limits. Hence, people in the particular CKDu endemic areas are at risk of kidney tissue damage due to long-term exposure to drinking water with elevated levels of some metal ions and counterions.

scholarly journals Risk Assessment of Trace Element Contamination in Drinking Water and Agricultural Soil: A Study in Selected Chronic Kidney Disease of Unknown Etiology (CKDu) Endemic Areas in Sri Lanka

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
W. P. R. T. Perera ◽  
M. D. N. R. Dayananda ◽  
D. M. U. C. Dissanayake ◽  
R. A. S. D. Rathnasekara ◽  
W. S. M. Botheju ◽  
...  
Keyword(s):  
Heavy Metals ◽  
Chronic Kidney Disease ◽  
Drinking Water ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Toxic Metals ◽  
Paddy Soil ◽  
Agricultural Soil ◽  
Unknown Etiology ◽  
Endemic Areas

Unexplained or unclear etiology of chronic kidney disease (CKDu) has been reported in Sri Lanka’s North Central Province (NCP) for more than two decades. Meanwhile, high exposure to heavy metals/metalloids and their accumulation are recognized as the origin of many acute and chronic diseases in certain vulnerable human tissues including kidneys. This study evaluates the contamination status of heavy metals/metalloids of the drinking water and agricultural soil in two CKDu endemic areas compared with a reference area in Sri Lanka based on common indexes and attribute of the commonly used fertilizers evaluated to identify the basic sources of toxic metals in the agricultural soil. Mean concentrations of heavy metals/metalloids such as Mn, Co, As, Cd, Pb, Cu, Zn, and Fe in drinking water of CKDu endemic areas were far below Sri Lankan water quality standards (permissible limits). In addition, all sampling locations dropped below the medium range of the heavy metal pollution index of water (HPI 15–40). Geoaccumulation indexes (Igeo) of soil reveal that paddy soil in CKDu endemic areas is being moderately polluted with toxic metals/metalloids such as As, Pb, Cu, Ni, Cr, Zn, and Cd. On the other hand, the application of fertilizers, which contained a high dose of toxic metals, could be the driving force for agricultural soil pollution, and limitless application of low-quality fertilizer would lead to more soil contamination with heavy metals. Hence, hazardous metals can be incorporated into the food chains via contaminated paddy soil.

scholarly journals Natural and Anthropogenic Controls of Groundwater Quality in Sri Lanka: Implications for Chronic Kidney Disease of Unknown Etiology (CKDu)

Water ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 2724
Author(s):  
Sen Xu ◽  
Si-Liang Li ◽  
Fujun Yue ◽  
Charitha Udeshani ◽  
Rohana Chandrajith
Keyword(s):  
Chronic Kidney Disease ◽  
Land Use ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Environmental Factors ◽  
Groundwater Quality ◽  
Water Hardness ◽  
Unknown Etiology ◽  
Groundwater Geochemistry ◽  
Guideline Values

Poor groundwater quality in household wells is hypothesized as being a potential contributor to chronic kidney disease of unknown etiology (CKDu) in Sri Lanka. However, the influencing factors of groundwater quality in Sri Lanka are rarely investigated at a national scale. Here, the spatial characteristics of groundwater geochemistry in Sri Lanka were described. The relationships of groundwater quality parameters with environmental factors, including lithology, land use, and climatic conditions, were further examined to identify the natural and anthropogenic controlling factors of groundwater quality in Sri Lanka. The results showed that groundwater geochemistry in Sri Lanka exhibited significant spatial heterogeneity. The high concentrations of NO3− were found in the districts that have a higher percentage of agricultural lands, especially in the regions in the coastal zone. Higher hardness and fluoride in groundwater were mainly observed in the dry zone. The concentrations of trace elements such as Cd, Pb, Cu, and Cr of all the samples were lower than the World Health Organization guideline values, while some the samples had higher As and Al concentrations above the guideline values. Principal component analysis identified four components that explained 73.2% of the total data variance, and the first component with high loadings of NO3−, hardness, As, and Cr suggested the effects of agricultural activities, while other components were primarily attributed to natural sources and processes. Further analyses found that water hardness, fluoride and As concentration had positive correlations with precipitation and negative correlations with air temperature. The concentration of NO3− and water hardness were positively correlated with agricultural lands, while As concentration was positively correlated with unconsolidated sediments. The environmental factors can account for 58% of the spatial variation in the overall groundwater geochemistry indicated by the results of redundancy analysis. The groundwater quality data in this study cannot identify whether groundwater quality is related to the occurrence of CKDu. However, these findings identify the coupled controls of lithology, land use, and climate on groundwater quality in Sri Lanka. Future research should be effectively designed to clarify the synergistic effect of different chemical constituents on CKDu.

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

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

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

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

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

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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