Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka

Chronic kidney disease of unknown (“u”) cause (CKDu) is a growing public health concern in Sri Lanka. Prior research has hypothesized a link with drinking water quality, but rigorous studies are lacking. This study assesses the relationship between nephrotoxic elements (namely arsenic (As), cadmium...

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Main Authors: Rango, T., Jeuland, M., Manthrithilake, Herath, McCornick, Peter G.
Format: Journal Article
Language:Inglés
Published: Elsevier 2015
Subjects:
Online Access:https://hdl.handle.net/10568/83472
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author Rango, T.
Jeuland, M.
Manthrithilake, Herath
McCornick, Peter G.
author_browse Jeuland, M.
Manthrithilake, Herath
McCornick, Peter G.
Rango, T.
author_facet Rango, T.
Jeuland, M.
Manthrithilake, Herath
McCornick, Peter G.
author_sort Rango, T.
collection Repository of Agricultural Research Outputs (CGSpace)
description Chronic kidney disease of unknown (“u”) cause (CKDu) is a growing public health concern in Sri Lanka. Prior research has hypothesized a link with drinking water quality, but rigorous studies are lacking. This study assesses the relationship between nephrotoxic elements (namely arsenic (As), cadmium (Cd), lead (Pb), and uranium (U)) in drinking water, and urine samples collected from individuals with and/or without CKDu in endemic areas, and from individuals without CKDu in nonendemic areas. All water samples – from a variety of source types (i.e. shallow and deep wells, springs, piped and surface water) – contained extremely low concentrations of nephrotoxic elements, and all were well below drinking water guideline values. Concentrations in individual urine samples were higher than, and uncorrelated with, those measured in drinking water, suggesting potential exposure from other sources. Mean urinary concentrations of these elements for individuals with clinically diagnosed CKDu were consistently lower than individuals without CKDu both in endemic and nonendemic areas. This likely stems from the inability of the kidney to excrete these toxic elements via urine in CKDu patients. Urinary concentrations of individuals were also found to be within the range of reference values measured in urine of healthy unexposed individuals from international biomonitoring studies, though these reference levels may not be safe for the Sri Lankan population. The results suggest that CKDu cannot be clearly linked with the presence of these contaminants in drinking water. There remains a need to investigate potential interactions of low doses of these elements (particularly Cd and As) with other risk factors that appear linked to CKDu, prior to developing public health strategies to address this illness.
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spelling CGSpace834722025-03-11T09:50:20Z Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka Rango, T. Jeuland, M. Manthrithilake, Herath McCornick, Peter G. drinking water nephrotoxicity contamination urine kidney diseases chronic course collective farming communities public health health hazards water quality elements arsenic compounds sampling analytical methods Chronic kidney disease of unknown (“u”) cause (CKDu) is a growing public health concern in Sri Lanka. Prior research has hypothesized a link with drinking water quality, but rigorous studies are lacking. This study assesses the relationship between nephrotoxic elements (namely arsenic (As), cadmium (Cd), lead (Pb), and uranium (U)) in drinking water, and urine samples collected from individuals with and/or without CKDu in endemic areas, and from individuals without CKDu in nonendemic areas. All water samples – from a variety of source types (i.e. shallow and deep wells, springs, piped and surface water) – contained extremely low concentrations of nephrotoxic elements, and all were well below drinking water guideline values. Concentrations in individual urine samples were higher than, and uncorrelated with, those measured in drinking water, suggesting potential exposure from other sources. Mean urinary concentrations of these elements for individuals with clinically diagnosed CKDu were consistently lower than individuals without CKDu both in endemic and nonendemic areas. This likely stems from the inability of the kidney to excrete these toxic elements via urine in CKDu patients. Urinary concentrations of individuals were also found to be within the range of reference values measured in urine of healthy unexposed individuals from international biomonitoring studies, though these reference levels may not be safe for the Sri Lankan population. The results suggest that CKDu cannot be clearly linked with the presence of these contaminants in drinking water. There remains a need to investigate potential interactions of low doses of these elements (particularly Cd and As) with other risk factors that appear linked to CKDu, prior to developing public health strategies to address this illness. 2015-06 2017-09-12T09:55:15Z 2017-09-12T09:55:15Z Journal Article https://hdl.handle.net/10568/83472 en Open Access Elsevier Rango, T.; Jeuland, M.; Manthrithilake, Herath; McCornick, Peter. 2015. Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka. Science of the Total Environment, 518-519:574-585. doi: 10.1016/j.scitotenv.2015.02.097
spellingShingle drinking water
nephrotoxicity
contamination
urine
kidney diseases
chronic course
collective farming
communities
public health
health hazards
water quality
elements
arsenic compounds
sampling
analytical methods
Rango, T.
Jeuland, M.
Manthrithilake, Herath
McCornick, Peter G.
Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka
title Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka
title_full Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka
title_fullStr Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka
title_full_unstemmed Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka
title_short Nephrotoxic contaminants in drinking water and urine, and chronic kidney disease in rural Sri Lanka
title_sort nephrotoxic contaminants in drinking water and urine and chronic kidney disease in rural sri lanka
topic drinking water
nephrotoxicity
contamination
urine
kidney diseases
chronic course
collective farming
communities
public health
health hazards
water quality
elements
arsenic compounds
sampling
analytical methods
url https://hdl.handle.net/10568/83472
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