Patient perceptions of risk factors for chronic kidney disease and methods of delaying progression of the disease in a tertiary care setting in Sri Lanka

Rathnamalala, Nadeeka; Nagodavithana, KC; Mihirini, A. T. H.; Lanerolle, Rushika

doi:10.1111/j.1742-1241.2011.02740.x

Cited by 2 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These materials have been settled in the bottom, undisturbed for centuries but now are pushed back into the water. These substances include heavy metals and other toxic compounds, are now contaminating the human food chain [20,100]. Thus, the failure to adopt proper soil and water conservation measures throughout the country not only adds to water scarcity, but also to water contamination and human ill health, and among others, may contribute to the CKD-mfo epidemic.…”

Section: Negative Effects Of Frequent Dredging Of Canals and Reservoirsmentioning

confidence: 99%

“…Worldwide, CKD of unknown/uncertain aetiology has been reported after chronic exposure to certain heavy metals, including arsenic, cadmium, mercury, chromium, uranium, gold, platinum, silver, thallium, and antimony, as well as fluoride [4,19,20] and agrochemicals [7][8][9][10][11]. Despite the epidemiological studies carried out over the past 40 years, other than the reported associations and correlations (except arsenic in ground-water, Bihar, India), no causative factor has been identified for CKDu across the continent.…”

Section: Postulated Causes For Ckd-mfomentioning

confidence: 99%

See 1 more Smart Citation

Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations

Wimalawansa

2014

Environ Health Prev Med

125

View full text Add to dashboard Cite

During the last two decades, Sri Lanka, located close to the equator, has experienced an escalating incidence of chronic kidney disease (CKD) of unknown aetiology (CKDue) in dry zonal areas. Similar incidences of unusual CKDs have been reported in the dry zonal, agricultural areas of several other equatorial countries. In Sri Lanka, the incidence of CKDue is highest in the North Central Province (NCP), where approximately 45 % of the country's paddy fields are located. However, in recent years, the disease has spread into areas adjacent to as well as distant from the NCP. The cause of CKD in Sri Lanka is unknown, and may likely due to interactions of different potential agents; thus, CKD is of multi-factorial origin (CKD-mfo). These factors include, the negative effects from overuse of agrochemicals. Nevertheless, the potential interactions and synergism between probable agents have not been studied. This systematic review discusses the proposed hypotheses and causes of CKD-mfo in Sri Lanka, and ways to decrease the incidence of this disease and to eradicate it, and provide some recommendations. During the past decade, a number of groups have investigated this disorder using different methodologies and reported various correlations, but failed to find a cause. Research has focussed on the contamination of water with heavy metals, agrochemicals, hard water, algae, ionicity, climate change, and so forth. Nevertheless, the levels of any of the pollutants or conditions reported in water in NPC are inconsistent not correlated with the prevalence of the disease, and are too low to be the sole cause of CKD-mfo. Meanwhile, several nephrotoxins prevalent in the region, including medications, leptospirosis, toxic herbs, illicit alcohol, locally grown tobacco, and petrochemicals, as well as the effects of changed habits occured over the past four decades have not been studied to date. Taken together, the geographical distribution and overall findings indicate that combinations of factors and/or their interactions are likely to precipitate CKD-mfo, which kills more than 5,000 people annually in Sri Lanka; most victims are middleaged male farmers. Much anecdotal evidence from this region suggests that consumption of contaminated water is the most likely source of this deadly disease. Although the aetiology is unknown, prevention of this ''environmentally acquired'' disease seems relatively straightforward. Solutions include (a) preventing environmental pollution, (b) stopping the irresponsible use and decreasing the usage of agrochemicals, and encouraging the use of environmentally friendly agricultural methods, (c) taking proper precautions when using agrochemicals and safe disposal of their containers, (d) changing the risky behaviour of farmers and educating them to preserve the environment, and (e) providing clean potable water to all affected regions. Implementing a well-coordinated, in-depth, region-wide, broad-based research study together with a long-term effective surveillance programme across the country i...

show abstract

Section: Negative Effects Of Frequent Dredging Of Canals and Reservoirsmentioning

confidence: 99%

Section: Postulated Causes For Ckd-mfomentioning

confidence: 99%

Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations

Wimalawansa

2014

Environ Health Prev Med

125

View full text Add to dashboard Cite

show abstract

“…The data and reports from studies, such as the WHO-CKDu [15,16], collaborative Japanese studies and several others [12,18,21,26,27] have failed to support any of the hypotheses regarding potential cause(s) of CKDmfo. The later includes, heavy metals, fluoride, hardness of water, ionicity, and agrochemicals (such as glyphosate, toxaphene, organochlorine and organophosphate pesticides, nitrates, or phosphates) [15,16,28].…”

Section: Environmental Pollution Related Chronic Kidney Diseasementioning

confidence: 99%

“…Water pollution secondary to expanding agricultural sector and human settlements, poor planning of drainage and safe sanitary facilities, pollution related to the industrial sector, and neglected or sub-optimal watershed management practices [7,8] all contribute to a shortage of clean drinking water [9][10][11]. In addition, the failure to adopt proper soil and water conservation measures, lack of clean air and clean water policies, irresponsible use of agrochemicals, and lack of enforcement of environmental laws and a nationwide long-term sustainable water plan, further increase the scarcity of clean water [6,12], and escalate the incidences of chronic human ill-health.…”

Section: Introductionmentioning

confidence: 99%

Agrochemicals and Chronic Kidney Disease of Multi-Factorial Origin: Environmentally Induced Occupational Exposure An Occupational Exposure Disease

J¹

2015

Int J Nephrol Kidney Failure

View full text Add to dashboard Cite

The contamination of food and water through waste and agricultural runoff poses serious threats to humans. Pollution with microbes causes noticeable diarrheal diseases, whereas agrochemicals, heavy metals, fluoride, and toxins cause insidious diseases and premature deaths. Chronic kidney disease of unknown origin (CKDuo) was first seen in dry-zonal agricultural regions in equatorial countries in the mid-1960s, and in Sri Lanka, in mid-1990s. A number of agents and toxins have been postulated as the cause of CKD of multifactorial origin (CKDmfo/CKDuo), including heavy metals, agrochemicals, fluoride, fungal and bacterial toxins, climate change; and a number of behavioral factors. Meanwhile, several other potential nephrotoxic causes have not been investigated, including the indiscriminate and excessive use of non-steroidal antiinflammatory drugs, illegal drugs and illicit alcohol, microbial agents (leptospirosis, Hanta virus etc.), chronic dehydration, and exposure to various combinations of these toxic agents in the presence of unhealthy habits. The incidence of CKDmfo is doubling every 4 to 5 years in Sri Lanka, leading to more than 5,000 deaths annually; excess of 150,000 people are currently affected. Although a number of agents have been postulated, no single offending agent has been identified as the cause of CKDmfo. To alleviate CKDmfo, it is essential to take a broader, holistic approach: carry out a massive awareness campaign, prevent environmental pollution, lessen malnutrition, correct unhealthy behaviors and habits acquired during recent past, and provide clean water completely devoid of nephrotoxins to all inhabitants in the affected communities. A sustained, coordinated, targeted, and effective approach is essential to decrease the disease incidence, prevention of premature deaths, and eradication of CKDmfo. This review explores pros and cons of agrochemicals as a potential cause of this deadly disease.

show abstract

Patient perceptions of risk factors for chronic kidney disease and methods of delaying progression of the disease in a tertiary care setting in Sri Lanka

Cited by 2 publications

References 4 publications

Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations

Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations

Agrochemicals and Chronic Kidney Disease of Multi-Factorial Origin: Environmentally Induced Occupational Exposure An Occupational Exposure Disease

Contact Info

Product

Resources

About