Does fluoride cause the mysterious chronic kidney disease of multifactorial origin?

Wimalawansa, Sunil J.

doi:10.1007/s10653-019-00503-3

Cited by 21 publications

(24 citation statements)

References 101 publications

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“…Another potential environmental factor is exposure to heavy metals and their synergies with other environmental elements [ 46 , 47 ]. The Calvillo region has water wells with fluoride concentrations above international recommendations; this has been previously documented [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Histologic characterization and risk factors for persistent albuminuria in adolescents in a region of highly prevalent end-stage renal failure of unknown origin

Diaz¹,

Aguirre²,

Escalera³

et al. 2022

Clinical Kidney Journal

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Background End-stage renal failure of unknown origin (ESRD-UO) is a public health problem in Mexico and many regions of the world. The prevalence of ESRD-UO in Aguascalientes Mexico is one of the highest worldwide, particularly in adults between 20 and 40 years of age. Aim To screen adolescents for chronic kidney disease (CKD), identify risk factors, and histologically characterize adolescents with persistent albuminuria (pACR). Methodology This is a cross-sectional, observational, and comparative study of adolescents in whom serum creatinine and the albumin creatinine ratio (ACR) were determined when screening for CKD. A clinical evaluation and risk factor survey were conducted. Patients with an abnormal ACR (≥ 30 mg/gr) or a low glomerular filtration rate (GFR) (≤75 ml/min/1.73 m2) were reevaluated and a renal ultrasound was obtained (rUS). A kidney biopsy was performed in patients with pACR. Results Five-hundred and thirteen (513) students were included, 19 had pACR and 494 were controls. The prevalence of pACR was 3.7% (95%CI 2.1 – 5.3). Only one patient had a decreased GRF. None of the patients with pACR had anatomical abnormalities of the urinary tract by rUS. Patients with pACR had a decreased total renal volume in comparison with the control group (150 vs 195 ml/m2, p <0.01). Eighteen (18) kidney biopsies were performed, 72% had glomerulomegaly, and only one patient had mild fibrosis. Podocyte abnormalities were evident on electron microscopy: partial fusion (100%), microvillous degeneration (80%), and increased organelles (60%). Risk factors for pACR were: homestead proximity to maize crops, the use of pesticides at the father´s workplace, a family history of CKD, and blood pressure abnormalities. The body mass index and breastfeeding were protective factors. Conclusions The prevalence of pACR in adolescents in Aguascalientes is high, and histologic compromise is characterized by podocyte injury in the absence of fibrosis. The renal volume of pACR patients was decreased, suggesting oligonephronia. Exposure to environmental toxins such as pesticides, even prenatally, may be responsible for this pathological entity. Screening programs in adolescents by determining ACR are necessary in our milieu.

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Section: Discussionmentioning

confidence: 99%

Histologic characterization and risk factors for persistent albuminuria in adolescents in a region of highly prevalent end-stage renal failure of unknown origin

Diaz¹,

Aguirre²,

Escalera³

et al. 2022

Clinical Kidney Journal

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“…In contrast, we observe concentrations of F that are higher than guideline values, with 57% of samples over the suggested optimal level of 1.0 mg L −1 of F in Sri Lankan drinking water (SLS614:2013) 45 . High F levels are known to result in skeletal fluorosis in the dry zone of Sri Lanka 57 and are hypothesised to contribute to CKDu 58 . The significant negative correlation between F and Ca/Na and Mg/Na ratios suggests a silicate source.…”

Section: Discussionmentioning

confidence: 99%

The influence of water–rock interactions on household well water in an area of high prevalence chronic kidney disease of unknown aetiology (CKDu)

et al. 2021

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Poor drinking water quality in household wells is hypothesised as being a potential contributor to the high prevalence of chronic kidney disease of uncertain aetiology (CKDu) among the farming communities of the Medawachchiya area, Anuradhapura, Sri Lanka. One of the natural processes that can affect water quality is the dissolution of minerals contained within an aquifer by water–rock interactions (WRIs). Here we present a comprehensive assessment of WRIs and their influence on the water chemistry in household wells and spring waters in the Medawachchiya area by combining measurements of environmental isotopes, such as strontium, lithium and stable carbon isotopes and inorganic chemistry parameters, and modelling geochemical mass balance reactions between rainfall and groundwater samples. Our results reveal the presence of strontium, dissolved from both silicate and carbonate minerals, with high isotopic (87Sr/86Sr) ratios of up to 0.7316. Geochemical mass balance modelling and prior 87Sr/86Sr studies on the Wanni Complex bedrock suggest these strontium values may be the result of biotite dissolution. We also identify lithium and uranium contributed from the dissolution of silicates, albeit at concentrations too low to constitute a known health risk. In contrast, the levels of magnesium and calcium in our samples are high and demonstrate that, despite the felsic bedrock, well water chemistry in the Medawachchiya area is dominated by carbonate dissolution.

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“… 365 The mechanism for understanding the dose and time dependency of the effects of fluoride in the liver has been proposed. 421 …”

Section: Fluoride Toxicitymentioning

confidence: 99%

Chemical Aspects of Human and Environmental Overload with Fluorine

et al. 2021

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Over the last 100–120 years, due to the ever-increasing importance of fluorine-containing compounds in modern technology and daily life, the explosive development of the fluorochemical industry led to an enormous increase of emission of fluoride ions into the biosphere. This made it more and more important to understand the biological activities, metabolism, degradation, and possible environmental hazards of such substances. This comprehensive and critical review focuses on the effects of fluoride ions and organofluorine compounds (mainly pharmaceuticals and agrochemicals) on human health and the environment. To give a better overview, various connected topics are also discussed: reasons and trends of the advance of fluorine-containing pharmaceuticals and agrochemicals, metabolism of fluorinated drugs, withdrawn fluorinated drugs, natural sources of organic and inorganic fluorine compounds in the environment (including the biosphere), sources of fluoride intake, and finally biomarkers of fluoride exposure.

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Does fluoride cause the mysterious chronic kidney disease of multifactorial origin?

Cited by 21 publications

References 101 publications

Histologic characterization and risk factors for persistent albuminuria in adolescents in a region of highly prevalent end-stage renal failure of unknown origin

Histologic characterization and risk factors for persistent albuminuria in adolescents in a region of highly prevalent end-stage renal failure of unknown origin

The influence of water–rock interactions on household well water in an area of high prevalence chronic kidney disease of unknown aetiology (CKDu)

Chemical Aspects of Human and Environmental Overload with Fluorine

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