Wasana Hewa M S, Aluthpatabendi Dharshani, Kularatne W M T D, Wijekoon Pushpa, Weerasooriya Rohan, Bandara Jayasundera
Institute of Fundamental Studies, Hantana Road, Kandy, 20000, CP, Sri Lanka.
Department of Statistics and Computer Science, Faculty of Science, University of Peradeniya, Peradeniya, Sri Lanka.
Environ Geochem Health. 2016 Feb;38(1):157-68. doi: 10.1007/s10653-015-9699-7. Epub 2015 Apr 10.
High prevalence of chronic kidney disease of unknown etiology (CKDu) in some regions of the world is suspected mainly due to a toxin-mediated renal failure. We examined the incidence of CKDu and potable chemical water quality in a CKDu-affected region. This region has been identified as a high-risk zone for CKDu (location: latitude: 8.3500°-9.0000°, longitude: 80.3833°-81.3000°, North Central Province, NCP, Sri Lanka) by the World Health Organization (WHO). However, within this macro-region, small pockets of CKDu non-prevalence zones do exist; notably, the residents in those pockets consume spring water. Therefore, the drinking water quality of four areas, namely high-CKDu-prevalence areas (zone I), low-CKDu-prevalence area (zone II), the CKDu-free isolated pockets (zone III) and control areas (controls) were examined for F, Al, Cd, and As, and hardness and the statistical analysis were carried out to probe possible correlations among these parameters. The fluoride and hardness concentrations of water in zone III and control areas are much lower compared to zones I and II, and the water hardness is ~61 mg/L CaCO3. In zones I and II, the harness of drinking water is ~121-180 mg/L CaCO3; however, Al, Cd and As concentrations are almost comparable and below WHO recommendations. In most of the locations in zones I and II, the F concentration in drinking water is higher than the WHO recommendations. The peculiar distribution patterns of CKDu point to a synergic effect of trace elements in water for etiology of the disease.
世界上一些地区慢性肾脏病病因不明（CKDu）的高患病率主要被怀疑是由毒素介导的肾衰竭所致。我们调查了一个受CKDu影响地区的CKDu发病率和饮用水化学水质。该地区已被世界卫生组织（WHO）确定为CKDu的高风险区（位置：北纬8.3500° - 9.0000°，东经80.3833° - 81.3000°，斯里兰卡中北部省）。然而，在这个大区域内，确实存在一些CKDu非流行的小区域；值得注意的是，这些区域的居民饮用泉水。因此，我们检测了四个区域的饮用水质量，即高CKDu流行区（I区）、低CKDu流行区（II区）、无CKDu的孤立区域（III区）和对照区（对照组）的氟、铝、镉和砷含量以及硬度，并进行了统计分析，以探究这些参数之间可能的相关性。与I区和II区相比，III区和对照区水中的氟化物和硬度浓度要低得多，水硬度约为61mg/L碳酸钙。在I区和II区，饮用水硬度约为121 - 180mg/L碳酸钙；然而，铝、镉和砷的浓度几乎相当且低于WHO的建议值。在I区和II区的大多数地点，饮用水中的氟浓度高于WHO的建议值。CKDu的特殊分布模式表明水中微量元素对该疾病病因有协同作用。
