Chronic kidney disease of unknown aetiology in Sri Lanka and the exposure to environmental chemicals: a review of literature

Kulathunga, M. R. D. L.; Wijayawardena, Ayanka; Naidu, Ravi; Wijeratne, A.W.

doi:10.1007/s10653-019-00264-z

Cited by 56 publications

(34 citation statements)

References 46 publications

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“…The mechanism of Cr-associated nephrotoxicity is unknown. The kidney is considered to be a critical organ for Cr toxicity, and trivalent and hexavalent Cr compounds have been reported to accumulate in proximal convoluted tubules [45]. Cr-induced cytotoxicity, DNA damage, and oxidative stress have also been reported in animal kidneys [46,47].…”

Section: Discussionmentioning

confidence: 99%

Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease

et al. 2021

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Background: The prevalence of chronic kidney disease (CKD) is increasing annually in Taiwan. In addition to traditional risk factors, heavy metals contribute to the development of CKD. The aim of this study was to investigate associations among heavy metals and proteinuria and CKD in the general population in Southern Taiwan. We also explored the interaction and synergetic effects among heavy metals on proteinuria. Methods: We conducted a health survey in the general population living in Southern Taiwan between June 2016 and September 2018. Seven heavy metals were measured: blood lead (Pb) and urine nickel (Ni), chromium (Cr), manganese (Mn), arsenic (As), copper (Cu), and cadmium (Cd). Proteinuria was measured using reagent strips. CKD was defined as an estimated glomerular filtration rate (eGFR) of <60 mL/min/1.73 m2. Results: The mean age of the 2447 participants was 55.1 ± 13.2 years and included 977 males and 1470 females. Participants with high blood Pb and high urine Ni, Mn, Cu, and Cd were significantly associated with proteinuria. Interactions between blood Pb and urine Cr, and between urine Cd and Cu, had significant effects on proteinuria. The participants with high blood Pb and high urine Cu were significantly associated with an eGFR of <60 mL/min/1.73 m2. Conclusion: High blood Pb and high urine Cu may be associated with proteinuria and an eGFR of <60 mL/min/1.73 m2. High urine Ni, Mn, and Cd were significantly associated with proteinuria. Co-exposure to Cd and Cu, and Pb and Cr, may have synergistic effects on proteinuria.

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Section: Discussionmentioning

confidence: 99%

Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease

et al. 2021

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“…In Sri Lanka’s North Central region, notably the Medawachchiya District Secretariat Division of the Anuradhapura District which has some of the highest prevalence of CKDu 4 , 80% of the mostly farming population relies on groundwater for their daily water needs 5 , including drinking water. Previous reports have investigated potential environmental 6 , 7 , genetic 8 , occupational and social 3 , 9 , 10 risk factors for CKDu without generating conclusive evidence for specific causes. Recent studies have pointed towards an association between CKDu, groundwater chemistry and the water quality in household wells 11 – 14 , suggesting that the disease could be caused by hydrogeochemical factors such as high fluoride and water hardness, heavy metals and microbial contamination or combinations thereof.…”

Section: Introductionmentioning

confidence: 99%

The water chemistry and microbiome of household wells in Medawachchiya, Sri Lanka, an area with high prevalence of chronic kidney disease of unknown origin (CKDu)

McDonough

Meredith

Nikagolla

et al. 2020

Sci Rep

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Chronic kidney disease (CKD) of unknown etiology (CKDu) mostly affects agricultural communities in Central America, South Asia, Africa, but likely also in North America and Australia. One such area with increased CKDu prevalence is the Medawachchiya District Secretariat Division of the Anuradhapura District in the North Central Province of Sri Lanka. Recent research has focused on the presence of various microbial pathogens in drinking water as potential causal or contributing factors to CKDu, yet no study to date has performed a more comprehensive microbial and water chemistry assessment of household wells used for domestic water supply in areas of high CKDu prevalence. In this study, we describe the chemical composition and total microbial content in 30 domestic household wells in the Medawachchiya District Secretariat Division. While the chemical composition in the tested wells mostly lies within standard drinking water limits, except for high levels of fluoride (F), magnesium (Mg), sodium (Na), chloride (Cl) and calcium (Ca) in some samples, we find a frequent presence of cyanotoxin-producing Microcystis, confirming earlier studies in Sri Lanka. Since the total microbial content of drinking water also directly influences the composition of the human gut microbiome, it can be considered an important determinant of health. Several bacterial phyla were previously reported in the gut microbiome of patients with CKD. Using these bacteria phyla to define operational taxonomic units, we found that these bacteria also occur in the microbiome of the sampled well water. Based on available environmental data, our study demonstrates associations between the abundances of these bacteria with geographical distribution, well water temperature and likely fertilizer use in the local surface water catchment area of the individual household wells. Our results reinforce the recommendation that household wells with stagnant or infrequently used water should be purged prior to use for drinking water, bathing and irrigation. The latter is suggested because of the reported potential accumulation of bacterial toxins by agricultural crops. The observation that bacteria previously found in chronic kidney disease patients are also present in household wells requires a more detailed systematic study of both the human gut and drinking water microbiomes in CKDu patients, in relation to disease prevalence and progression.

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“…The reason for the prohibition of glyphosate was the allegation that it was causing a severe health problem called “chronic kidney disease of unknown etiology (CKDu)” in some agricultural areas of the country, which had escalated into an epidemic (Jayasumana et al, 2015; Rajapakse, Shivanthan, & Selvarajah, 2016). This unknown disease took the lives of more than 1,400 people annually and made up to 400,000 people ill in Sri Lanka (Kulathunga, Wijayawardena, Naidu, & Wijeratne, 2019). The ban of this critical agricultural input created a massive turmoil in the agriculture industry in the country, particularly the tea sector.…”

Section: Discussionmentioning

confidence: 99%

“…Kulathunga, Wijayawardena, Naidu, & Wijeratne, 2019). The ban of this critical agricultural input created a massive turmoil in the agriculture industry in the country, particularly the tea sector.This situation resulted in two types of problems in tea plantation companies such as Alpha.…”

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confidence: 99%

Eco‐control for corporate sustainable management: A sustainability development stage perspective

Gunarathne

Lee

2020

Corp Soc Responsibility Env

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Eco-control offers an integrated management approach to transitioning toward corporate sustainable development, such as sustainable agriculture management. Despite the need to consider organizational and managerial changes and development in the field of sustainable agriculture, the use of integrated management controls has not yet been explored. This study identifies how the eco-control procedures in sustainable agriculture management change when a commercial tea company transits to different stages of corporate sustainable development. It has developed an analytical framework, combining the sustainability management development perspective with the processual view of integrated eco-control. Using a longitudinal case study approach, the data have been collected via in-depth interviews, site visits, and document analyses, in respect of a commercial tea company in Sri Lanka. The findings show how the processual eco-controls have changed as a result of internal and external challenges faced in the different sustainability management development stages of the transition to sustainable agriculture management. The findings emphasize the need for gaining a better understanding of the actions and decisions at the field (operational) and organizational level in promoting sustainable agriculture management practices in agribusiness firms.

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Chronic kidney disease of unknown aetiology in Sri Lanka and the exposure to environmental chemicals: a review of literature

Cited by 56 publications

References 46 publications

Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease

Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease

The water chemistry and microbiome of household wells in Medawachchiya, Sri Lanka, an area with high prevalence of chronic kidney disease of unknown origin (CKDu)

Eco‐control for corporate sustainable management: A sustainability development stage perspective

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