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本文引用的文献

1
Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations.斯里兰卡日益严重的多因素起源慢性肾脏病:病因、解决方案及建议
Environ Health Prev Med. 2014 Nov;19(6):375-94. doi: 10.1007/s12199-014-0395-5. Epub 2014 Sep 20.
2
Chronic kidney disease of unknown aetiology and ground-water ionicity: study based on Sri Lanka.不明病因的慢性肾脏病与地下水电离子性:基于斯里兰卡的研究
Environ Geochem Health. 2015 Apr;37(2):221-31. doi: 10.1007/s10653-014-9641-4. Epub 2014 Aug 14.
3
Importance of Arsenic and pesticides in epidemic chronic kidney disease in Sri Lanka.砷和农药在斯里兰卡流行性慢性肾病中的重要性。
BMC Nephrol. 2014 Jul 28;15:124. doi: 10.1186/1471-2369-15-124.
4
Is the staple diet eaten in Medawachchiya, Sri Lanka, a predisposing factor in the development of chronic kidney disease of unknown etiology? - A comparison based on urinary β2-microglobulin measurements.在斯里兰卡的 Medawachchiya 常吃的主食是否是导致病因不明的慢性肾病的一个诱发因素?-基于尿β2-微球蛋白测量值的比较。
BMC Nephrol. 2014 Jul 2;15:103. doi: 10.1186/1471-2369-15-103.
5
Glyphosate, hard water and nephrotoxic metals: are they the culprits behind the epidemic of chronic kidney disease of unknown etiology in Sri Lanka?草甘膦、硬水和肾毒性金属:它们是斯里兰卡病因不明的慢性肾病流行背后的罪魁祸首吗?
Int J Environ Res Public Health. 2014 Feb 20;11(2):2125-47. doi: 10.3390/ijerph110202125.
6
Chronic kidney disease of unknown aetiology in Sri Lanka: is cadmium a likely cause?斯里兰卡病因不明的慢性肾病:镉可能是病因之一?
BMC Nephrol. 2011 Jul 5;12:32. doi: 10.1186/1471-2369-12-32.
7
Evidence of tubular damage in the very early stage of chronic kidney disease of uncertain etiology in the North Central Province of Sri Lanka: a cross-sectional study.斯里兰卡中北部地区病因不明的慢性肾脏病早期肾小管损伤的证据:一项横断面研究。
Environ Health Prev Med. 2012 Mar;17(2):109-17. doi: 10.1007/s12199-011-0224-z. Epub 2011 Jun 28.
8
Chronic kidney diseases of uncertain etiology (CKDue) in Sri Lanka: geographic distribution and environmental implications.斯里兰卡病因不明的慢性肾脏病(CKDue):地理分布和环境影响。
Environ Geochem Health. 2011 Jun;33(3):267-78. doi: 10.1007/s10653-010-9339-1. Epub 2010 Sep 18.
9
Cadmium, diabetes and chronic kidney disease.镉、糖尿病与慢性肾脏病
Toxicol Appl Pharmacol. 2009 Aug 1;238(3):289-93. doi: 10.1016/j.taap.2009.03.007. Epub 2009 Mar 24.
10
Chronic renal failure among farm families in cascade irrigation systems in Sri Lanka associated with elevated dietary cadmium levels in rice and freshwater fish (Tilapia).斯里兰卡梯级灌溉系统中农户的慢性肾衰竭与大米和淡水鱼(罗非鱼)中膳食镉含量升高有关。
Environ Geochem Health. 2008 Oct;30(5):465-78. doi: 10.1007/s10653-007-9129-6. Epub 2008 Jan 17.

饮用水和饮食中的氟化物:斯里兰卡中北部省份慢性肾脏病的致病因素

Fluoride in drinking water and diet: the causative factor of chronic kidney diseases in the North Central Province of Sri Lanka.

作者信息

Dharmaratne Ranjith W

机构信息

, 35, Sri Thapodarama Road, Hanthana, Kandy, 20000, Sri Lanka,

出版信息

Environ Health Prev Med. 2015 Jul;20(4):237-42. doi: 10.1007/s12199-015-0464-4. Epub 2015 Apr 28.

DOI:10.1007/s12199-015-0464-4
PMID:25916575
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4491063/
Abstract

A significant number of people in the North Central Province of Sri Lanka suffer from chronic kidney diseases (CKD), and the author revisits existing literature related to CKD to find its causative factor. There is a direct connection between high fluoride levels in drinking water and kidney disease, and there are unhealthy levels of fluoride in the groundwater in Sri Lanka's CKD-affected areas. Based on the following observations, the author believes with confidence that excess fluoride in drinking water and in the locally grown food in the affected areas are the culprits of CKD in Sri Lanka. Fluoride excretion rate is considerably lower in children than adults, leading to renal damage of children living in areas with high fluoride. Adults who had renal damage due to fluoride in childhood are vulnerable to CKD with continued consumption of water from the same source. Patients with chronic renal insufficiency are at an increased risk of chronic fluoride toxicity. High content of fluoride in groundwater paves the way to excess fluoride in local food crops, consequently adding more fluoride to the systems of the consumers. People who work outdoors for prolonged periods consume excess water and tea, and are subjected to additional doses of fluoride in their system. In the mid-1980s, the increase in water table levels of the affected areas due to new irrigation projects paved the way to adding more fluorides to their system through drinking water and locally grown foods.

摘要

斯里兰卡中北部省份有相当数量的人患有慢性肾病(CKD),作者重新审视了与CKD相关的现有文献以找出其致病因素。饮用水中高氟含量与肾脏疾病之间存在直接联系,并且在斯里兰卡受CKD影响地区的地下水中氟含量处于不健康水平。基于以下观察结果,作者坚信受影响地区饮用水和当地种植食物中的过量氟是斯里兰卡CKD的罪魁祸首。儿童的氟排泄率明显低于成年人,这会导致生活在高氟地区的儿童肾脏受损。童年时期因氟而肾脏受损的成年人,若继续饮用同一水源的水,则易患CKD。慢性肾功能不全患者慢性氟中毒的风险增加。地下水中的高氟含量导致当地粮食作物中氟过量,从而使消费者体内摄入更多氟。长时间在户外工作的人饮用过量的水和茶,体内会摄入额外剂量的氟。在20世纪80年代中期,新的灌溉项目导致受影响地区地下水位上升,通过饮用水和当地种植的食物使人们体内摄入更多氟。