Monday, 06 March 2017 10:04

Clinical Research: Prevalence of CKD and its association with exposure to heavy metals and other environmental toxins in a rural population in Sri Lanka

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Name: ErEranga Wijewickramaanga Wijewickrama

Hospital/Affiliation: Faculty of Medicine, University of Colombo

Home Country: Sri Lanka

Host Country: Sri Lanka

Year: started in 2017

Status of the program: IN PROGRESS

Title of the project:
Prevalence of chronic kidney disease and its association with exposure to heavy metals and other environmental toxins in a rural population in Sri Lanka


Short description of the project or abstract:
Chronic kidney disease is on the rise globally. The main contributory factors are the increased incidence of diabetes and hypertension. The situation is somewhat different in certain parts of Sri Lanka where the disease is reaching epidemic proportions in the absence of these traditional risk factors. This, CKD of uncertain aetiology, is predominantly seen in the North Central Province and involve the farming community belonging to the low socio-economic class. The absence of typical risk factors of CKD, restriction of the disease to certain geographical locations, its prevalence among farming communities and the histopathological findings suggest the involvement of a single or multiple environmental nephrotoxins in the aetiology of CKDu. Hardness of drinking water, fluoride, agrochemicals, heavy metals such as arsenic and cadmium are some of the postulated toxins however none have been proven to be associated with the disease.
Increasing numbers of CKD cases are being reported from certain areas of Moneragala district, which lie outside the general confines of CKDu endemic area in Sri Lanka. The actual prevalence of the disease and associated risk factors are not known. The proposed study is intended to identify the true prevalence of CKD in this rural high-risk region and to determine its association with the environmental nephrotoxins including heavy metals such as arsenic, cadmium and lead.
The study will be carried out in identified high risk areas of the Moneragala district and the selected individuals will be screened with serum creatinine, urine for albumin:creatinine ratio and β2 microglobulin levels. A detailed questionnaire will be used to identify exposures to possible environmental toxins. Levels of urinary arsenic, cadmium and lead will be measured in all in order to identify an association with CKD.
The study will not only have a research value but will have implications on screening, instituting preventative measures and treatment strategies for the individuals living in the area. The information obtained will also shed light on the aetiology and pathogenesis of CKD of unknown aetiology elsewhere in the world including Central America where the affected share certain work exposures with the inhabitants of this rural area in Moneragala.

Learning or research objectives:
In a rural population of Sri Lanka:
1.1:    To describe the prevalence of CKD
1.2:    To describe the prevalence of CKDu
1.3:    To describe the prevalence of β2 microglobulinuria
1.4:    To assess the role of environmental risk factors including heavy metals in the development of CKD and β2 microglobulinuria


Additional Info

  • Year: 2017
  • Status: In progress
  • Partners: ISN only
  • Region: South Asia
  • Country: Sri Lanka
  • Topics: CKD
Read 6723 times Last modified on Tuesday, 07 March 2017 09:39

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