Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study

Abstract A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prevalence across dry lowland agricultural communities globally. Here we present the results of a prospective cohort of 293 patients with CKDu in the endemic region of Wilgamuwa, Sri Lanka, in whom...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Penny Vlahos, Stephen L. Schensul, Shuchi Anand, Emma Shipley, Saranga Diyabalanage, Chaoran Hu, Toan Ha, Allison Staniec, Lalarukh Haider, Jean J. Schensul, Pasan Hewavitharane, Tudor Silva, Rohana Chandrajith, Nishantha Nanayakkara
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Water supply for domestic and industrial purposes TD201-500
Acceso en línea:	https://doaj.org/article/d164939b4f1043449a02d2adc1c25ca7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:d164939b4f1043449a02d2adc1c25ca7
record_format	dspace
spelling	oai:doaj.org-article:d164939b4f1043449a02d2adc1c25ca72021-12-05T12:16:49ZWater sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study10.1038/s41545-021-00141-22059-7037https://doaj.org/article/d164939b4f1043449a02d2adc1c25ca72021-12-01T00:00:00Zhttps://doi.org/10.1038/s41545-021-00141-2https://doaj.org/toc/2059-7037Abstract A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prevalence across dry lowland agricultural communities globally. Here we present the results of a prospective cohort of 293 patients with CKDu in the endemic region of Wilgamuwa, Sri Lanka, in whom we measured baseline kidney function and undertook quarterly follow up over 2 years. Well water was the primary historic drinking water source in the region, although a majority (68%) of participants reported switching to reverse osmosis water during study follow ups. Participants who reported ever drinking from well water had estimated glomerular filtration rates −6.7 (SD: 2.8) ml/min/1.73 m2 lower than participants who did not drink from well water historically (p = 0.0184) during the study period. Geospatial analysis identifies a cluster within the region where CKDu progression is significantly higher than the surrounding area. Samples of household wells (n = 262) indicated 68% had detectable agrochemical compounds with concentration above global water quality standards. It is expected that the detected contaminants compounds are indicators of poor water quality and that there is likely additional agrochemical exposure including commercial additives that may contribute to CKDu onset and/or progression. Thus, our study finds that well water exposure during a person’s lifetime in this region is associated with kidney function decline and identifies and quantifies putative nephrotoxic agrochemicals above safe drinking water concentrations in these wells.Penny VlahosStephen L. SchensulShuchi AnandEmma ShipleySaranga DiyabalanageChaoran HuToan HaAllison StaniecLalarukh HaiderJean J. SchensulPasan HewavitharaneTudor SilvaRohana ChandrajithNishantha NanayakkaraNature PortfolioarticleWater supply for domestic and industrial purposesTD201-500ENnpj Clean Water, Vol 4, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Water supply for domestic and industrial purposes TD201-500
spellingShingle	Water supply for domestic and industrial purposes TD201-500 Penny Vlahos Stephen L. Schensul Shuchi Anand Emma Shipley Saranga Diyabalanage Chaoran Hu Toan Ha Allison Staniec Lalarukh Haider Jean J. Schensul Pasan Hewavitharane Tudor Silva Rohana Chandrajith Nishantha Nanayakkara Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study
description	Abstract A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prevalence across dry lowland agricultural communities globally. Here we present the results of a prospective cohort of 293 patients with CKDu in the endemic region of Wilgamuwa, Sri Lanka, in whom we measured baseline kidney function and undertook quarterly follow up over 2 years. Well water was the primary historic drinking water source in the region, although a majority (68%) of participants reported switching to reverse osmosis water during study follow ups. Participants who reported ever drinking from well water had estimated glomerular filtration rates −6.7 (SD: 2.8) ml/min/1.73 m2 lower than participants who did not drink from well water historically (p = 0.0184) during the study period. Geospatial analysis identifies a cluster within the region where CKDu progression is significantly higher than the surrounding area. Samples of household wells (n = 262) indicated 68% had detectable agrochemical compounds with concentration above global water quality standards. It is expected that the detected contaminants compounds are indicators of poor water quality and that there is likely additional agrochemical exposure including commercial additives that may contribute to CKDu onset and/or progression. Thus, our study finds that well water exposure during a person’s lifetime in this region is associated with kidney function decline and identifies and quantifies putative nephrotoxic agrochemicals above safe drinking water concentrations in these wells.
format	article
author	Penny Vlahos Stephen L. Schensul Shuchi Anand Emma Shipley Saranga Diyabalanage Chaoran Hu Toan Ha Allison Staniec Lalarukh Haider Jean J. Schensul Pasan Hewavitharane Tudor Silva Rohana Chandrajith Nishantha Nanayakkara
author_facet	Penny Vlahos Stephen L. Schensul Shuchi Anand Emma Shipley Saranga Diyabalanage Chaoran Hu Toan Ha Allison Staniec Lalarukh Haider Jean J. Schensul Pasan Hewavitharane Tudor Silva Rohana Chandrajith Nishantha Nanayakkara
author_sort	Penny Vlahos
title	Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study
title_short	Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study
title_full	Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study
title_fullStr	Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study
title_full_unstemmed	Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study
title_sort	water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/d164939b4f1043449a02d2adc1c25ca7
work_keys_str_mv	AT pennyvlahos watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT stephenlschensul watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT shuchianand watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT emmashipley watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT sarangadiyabalanage watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT chaoranhu watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT toanha watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT allisonstaniec watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT lalarukhhaider watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT jeanjschensul watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT pasanhewavitharane watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT tudorsilva watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT rohanachandrajith watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy AT nishanthananayakkara watersourcesandkidneyfunctioninvestigatingchronickidneydiseaseofunknownetiologyinaprospectivestudy
_version_	1718372105161015296

Water sources and kidney function: investigating chronic kidney disease of unknown etiology in a prospective study

Ejemplares similares