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 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.

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

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 Impact of water quality on Chronic Kidney Disease of unknown etiology (CKDu) in Thunukkai Division in Mullaitivu District, Sri Lanka

2020 ◽  
Author(s):  
Kalaivani Gobalarajah ◽  
Subramaniam Prabagar ◽  
Uthpala Jayawardena ◽  
Rasiah Gobalarajah ◽  
Subramaniam Rajendra ◽  
...  
Keyword(s):  
Water Quality ◽  
Chronic Kidney Disease ◽  
Drinking Water ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Negative Relationship ◽  
Total Hardness ◽  
Unknown Etiology ◽  
Arsenic Content ◽  
Total Dissolved Solid

Abstract BackgroundIncrease in the number of cases in Chronic Kidney Disease of Unknown etiology (CKDu) in Sri Lanka has become an environmental health issue of national concern. Even though, Northern Province is not identified as a high risk province, there is an increasing trend of CKDu after the end of civil war in the Northern territory.MethodsThe present study was conducted in Thunukkai Division in Mullaitivu District to investigate the socio demographic and clinical pattern of CKDu patients and to evaluate the quality of their water sources. The samples were selected by using stratified purposive random sampling method which represented 29% of total CKDu patients in Thunukkai Division. Pretested structured questionnaire was administrated to collect the data from CKDu patients.ResultsAmong the patients, 80% of them were male with an age range of 30-80, majority (88%) involved in farming. 26% and 20% of people were engaged in smoking and taking alcohol, respectively. 17% and 43% were suffered with diabetes and hypertension, respectively. Physicochemical characteristics of more than 50% of the water samples recorded higher electric conductivity, salinity, total dissolved solids, total hardness and Na levels compared to drinking water standards in Sri Lanka.ConclusionsThe association between serum creatine excreted by CKDu patients and water quality parameters were determined by using regression model, revealing a significant negative relationship with phosphate and positive relationship with Total Dissolved Solid and arsenic content of the drinking water. Thus, the study suggests, total dissolved solid and arsenic in drinking water have a positive correlation with CKDu in Thunukkai region in the Mullaitivu District.

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 Impact of water quality on Chronic Kidney Disease of unknown etiology (CKDu) in Thunukkai Division in Mullaitivu District, Sri Lanka

2020 ◽  
Author(s):  
Kalaivani Gobalarajah ◽  
Subramaniam Prabagar ◽  
Uthpala Jayawardena ◽  
Rasiah Gobalarajah ◽  
Subramaniam Rajendra ◽  
...  
Keyword(s):  
Water Quality ◽  
Chronic Kidney Disease ◽  
Drinking Water ◽  
Sri Lanka ◽  
Kidney Disease ◽  
Negative Relationship ◽  
Total Hardness ◽  
Unknown Etiology ◽  
Arsenic Content ◽  
Total Dissolved Solid

Abstract Background Increase in the number of cases in Chronic Kidney Disease of Unknown etiology (CKDu) in Sri Lanka has become an environmental health issue of national concern. Even though, Northern Province is not identified as a high risk province, there is an increasing trend of CKDu after the end of civil war in the Northern territory. Methods The present study was conducted in Thunukkai Division in Mullaitivu District to investigate the socio demographic and clinical pattern of CKDu patients and to evaluate the quality of their water sources. The samples were selected by using stratified purposive random sampling method which represented 29% of total CKDu patients in Thunukkai Division. Pretested structured questionnaire was administrated to collect the data from CKDu patients. Results Among the patients, 80% of them were male with an age range of 30-80, majority (88%) involved in farming. 26% and 20% of people were engaged in smoking and taking alcohol, respectively. 17% and 43% were suffered with diabetes and hypertension, respectively. Physicochemical characteristics of more than 50% of the water samples recorded higher electric conductivity, salinity, total dissolved solids, total hardness and Na levels compared to drinking water standards in Sri Lanka. Conclusions The association between serum creatine excreted by CKDu patients and water quality parameters were determined by using regression model, revealing a significant negative relationship with phosphate and positive relationship with Total Dissolved Solid and arsenic content of the drinking water. Thus, the study suggests, total dissolved solid and arsenic in drinking water have a positive correlation with CKDu in Thunukkai region in the Mullaitivu District.

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