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Pallagae Mangala C S De Silva, Khaja Shameem Mohammed Abdul, Eakanayake M D V Eakanayake, Sudheera Sammanthi Jayasinghe, Channa Jayasumana, Hewa Bandulage Asanthi, Hettiarachigae S D Perera, Gamage G Tushara Chaminda, Ediriweera P S Chandana, Sisira H Siribaddana
Chronic Kidney Disease of uncertain etiology (CKDu) is an emerging epidemic among farming communities in rural Sri Lanka. Victims do not exhibit common causative factors, however, histopathological studies revealed that CKDu is a tubulointerstitial disease. Urine albumin or albumin-creatinine ratio is still being used as a traditional diagnostic tool to identify CKDu, but accuracy and prevalence data generated are questionable. Urinary biomarkers have been used in similar nephropathy and are widely recognised for their sensitivity, specificity and accuracy in determining CKDu and early renal injury...
September 2016: PLoS Neglected Tropical Diseases
Keith E Levine, Jennifer Hoponick Redmon, Myles F Elledge, Kamani P Wanigasuriya, Kristin Smith, Breda Munoz, Vajira A Waduge, Roshini J Periris-John, Nalini Sathiakumar, James M Harrington, Donna S Womack, Rajitha Wickremasinghe
The emergence of a new form of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka's North Central Province (NCP) has become a catastrophic health crisis. CKDu is characterized as slowly progressing, irreversible, and asymptomatic until late stages and, importantly, not attributed to diabetes, hypertension, or other known risk factors. It is postulated that the etiology of CKDu is multifactorial, involving genetic predisposition, nutritional and dehydration status, exposure to one or more environmental nephrotoxins, and lifestyle factors...
October 2015: Environmental Monitoring and Assessment
Fiona Gifford, Robert Kimmitt, Chula Herath, David J Webb, Vanessa Melville, Sisira Siribaddana, Michael Eddleston, Neeraj Dhaun
Chronic kidney disease (CKD) is common and independently associated with cardiovascular disease (CVD). Arterial stiffness contributes to CVD risk in CKD. In many developing countries a considerable proportion of CKD remains unexplained, termed CKDu. We assessed arterial stiffness in subjects with Sri Lankan CKDu, in matched controls without CKD and in those with defined CKD. Aortic blood pressure (BP), pulse wave velocity (PWV) and augmentation index (AIx) were assessed in 130 subjects (50 with CKDu, 45 with CKD and 35 without CKD) using the validated TensioMed™ Arteriograph monitor...
2016: Scientific Reports
Zeid Badurdeen, Nishantha Nanayakkara, Neelakanthi V I Ratnatunga, Abdul W M Wazil, Tilak D J Abeysekera, Premil N Rajakrishna, Jalitha P Thinnarachchi, Ranjith Kumarasiri, Dulani D Welagedera, Needika Rajapaksha, Adambarage P D Alwis
INTRODUCTION: The majority of published data on chronic kidney disease of uncertain etiology (CKDu) is on asymptomatic patients who were detected in screening programs. The clinicopathological profile of a group of patients presenting with acute symptoms and renal dysfunction from CKDu endemic regions in Sri Lanka was studied. METHODS: 59 patients > 10 years of age with backache, feverish fatigue feeling, dysuria, joint pain, or dyspepsia, singly or in combination with elevated serum creatinine (> 116 and > 98 µmol/L for male and females, respectively) were included in the study...
July 29, 2016: Clinical Nephrology
Senaka Rajapakse, Mitrakrishnan Chrishan Shivanthan, Mathu Selvarajah
INTRODUCTION: In the last two decades, chronic kidney disease of unknown etiology (CKDu) has emerged as a significant contributor to the burden of chronic kidney disease (CKD) in rural Sri Lanka. It is characterized by the absence of identified causes for CKD. The prevalence of CKDu is 15.1-22.9% in some Sri Lankan districts, and previous research has found an association with farming occupations. METHODS: A systematic literature review in Pubmed, Embase, Scopus, and Lilacs databases identified 46 eligible peer-reviewed articles and one conference abstract...
July 11, 2016: International Journal of Occupational and Environmental Health
Chandika Damesh Gamage, Yomani Dilukshi Sarathkumara
Chronic kidney disease of uncertain etiology (CKDu) has been a severe burden and a public health crisis in Sri Lanka over the past two decades. Many studies have established hypotheses to identify potential risk factors although causative agents, risk factors and etiology of this disease are still uncertain. Several studies have postulated that fungal and bacterial nephrotoxins are a possible etiological factor; however, the precise link between hypothesized risk factors and the pathogenesis of chronic kidney disease has yet to be proven in prior studies...
June 2016: Medical Hypotheses
Joseph Lunyera, Dinushika Mohottige, Megan Von Isenburg, Marc Jeuland, Uptal D Patel, John W Stanifer
BACKGROUND AND OBJECTIVES: Epidemics of CKD of uncertain etiology (CKDu) are emerging around the world. Highlighting common risk factors for CKD of uncertain etiology across various regions and populations may be important for health policy and public health responses. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We searched PubMed, Embase, Scopus and Web of Science databases to identify published studies on CKDu. The search was generated in January of 2015; no language or date limits were used...
March 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
S Wijetunge, N V I Ratnatunga, T D J Abeysekera, A W M Wazil, M Selvarajah
Chronic kidney disease of unknown etiology (CKDU) is endemic among the rural farming communities in several localities in and around the North Central region of Sri Lanka. This is an interstitial type renal disease and typically has an insidious onset and slow progression. This study was conducted to identify the pathological features in the different clinical stages of CKDU. This is a retrospective study of 251 renal biopsies identified to have a primary interstitial disease from regions endemic for CKDU. Pathological features were assessed and graded in relation to the clinical stage...
September 2015: Indian Journal of Nephrology
Risako Kabata, Shanika Nanayakkara, Stmld Senevirathna, Kouji H Harada, Rohana Chandrajith, Toshiaki Hitomi, Tilak Abeysekera, Takumi Takasuga, Akio Koizumi
OBJECTIVES: Neonicotinoid insecticides have been widely used around the world since the 1990s. Reports have been made since the 1990s of rice paddy farmers in the North Central Region (NCR) of Sri Lanka suffering from chronic kidney disease with unknown etiology (CKDu). A preliminary evaluation of the exposure of local farmers in the NCR of Sri Lanka to neonicotinoids was performed. METHODS: We analyzed neonicotinoid and neonicotinoid metabolite concentrations in spot urine samples...
2016: Journal of Occupational Health
Sunil J Wimalawansa
The pollution of water and food through human waste and anthropogenic activities, including industrial waste and agricultural runoff, is a mounting problem worldwide. Water pollution from microbes causes identifiable diarrhoeal illnesses. The consumption of water contaminated with heavy metals, fluoride, and other toxins causes insidious illnesses that lead to protracted, non-communicable diseases and death. Chronic kidney disease of unusual/uncertain/unknown aetiology is one such example, began to manifest in the mid-1960s in several dry-zonal agricultural societies in developing economies that are located around the equator...
June 2016: Environmental Geochemistry and Health
Huang-Yu Yang, Cheng-Chieh Hung, Su-Hsun Liu, Yi-Gen Guo, Yung-Chang Chen, Yi-Ching Ko, Chiung-Tseng Huang, Li-Fang Chou, Ya-Chung Tian, Ming-Yang Chang, Hsiang-Hao Hsu, Ming-Yen Lin, Shang-Jyh Hwang, Chih-Wei Yang
BACKGROUND: Leptospirosis is the most widespread zoonosis. Chronic human infection and asymptomatic colonization have been reported. However, renal involvement in those with leptospira chronic exposure remains undetermined. METHODS AND FINDINGS: In 2007, a multistage sampling survey for chronic kidney disease (CKD) was conducted in a southern county of Taiwan, an area with a high prevalence of dialysis. Additionally, an independent cohort of 88 participants from a leptospira-endemic town was followed for two years after a flooding in 2009...
2015: PLoS Neglected Tropical Diseases
Virginia M Weaver, Jeffrey J Fadrowski, Bernard G Jaar
No abstract text is available yet for this article.
2015: BMC Nephrology
Shanika Nanayakkara, S T M L D Senevirathna, Nipuna B Parahitiyawa, Tilak Abeysekera, Rohana Chandrajith, Neelakanthi Ratnatunga, Toshiaki Hitomi, Hatasu Kobayashi, Kouji H Harada, Akio Koizumi
OBJECTIVES: The familial clustering observed in chronic kidney disease of uncertain etiology (CKDu) characterized by tubulointerstitial damages in the North Central Region of Sri Lanka strongly suggests the involvement of genetic factors in its pathogenesis. The objective of the present study is to use whole-exome sequencing to identify the genetic variants associated with CKDu. METHODS: Whole-exome sequencing of eight CKDu cases and eight controls was performed, followed by direct sequencing of candidate loci in 301 CKDu cases and 276 controls...
September 2015: Environmental Health and Preventive Medicine
Fahim Mohamed, Zoltan H Endre, Nicholas A Buckley
Acute kidney injury (AKI) has diverse causes and is associated with increased mortality and morbidity. In less developed countries (LDC), nephrotoxic AKI (ToxAKI) is common and mainly due to deliberate ingestion of nephrotoxic pesticides, toxic plants or to snake envenomation. ToxAKI shares some pathophysiological pathways with the much more intensively studied ischaemic AKI, but in contrast to ischaemic AKI, most victims are young, previously healthy adults. Diagnosis of AKI is currently based on a rise in serum creatinine...
July 2015: British Journal of Clinical Pharmacology
E A R I E Siriwardhana, P A J Perera, R Sivakanesan, T Abeysekara, D B Nugegoda, J A A S Jayaweera
Chronic kidney disease (CKD) of unknown etiology (CKDu) is a serious health issue in Sri Lanka. One-to-one age and sex-matched two sample comparative study was carried out in the Medawachchiya divisional secretariat area of the North Central Province (NCP) of Sri Lanka, by randomly selecting 100 CKDu patients and 100 age and sex-matched subjects from non-CKDu affected families from the same area. An interviewer-administered questionnaire was used for the collection of data pertaining to occupation, medical history and lifestyle...
May 2015: Indian Journal of Nephrology
Xuexue Xing, Jing Lu, Zheng Wang
BACKGROUND: Apart from the well-known etiologies, there are still a high proportion of patients with chronic kidney disease of unknown etiology (CKDu), which has rarely been reported on. In this study, we explored the potential associated risk factors for CKDu and identified those that occur in childhood. METHODS: 700 patients with CKD we were selected randomly from 4 hospitals in Chengdu and 241 were screened for CKDu. The following clinical information was analyzed: demographic data, life style, personal and family history, nephrotoxic drugs, exposure to poison, allergies, and recurrent respiratory infections in childhood...
April 2015: International Journal of Artificial Organs
Hewa M S Wasana, Dharshani Aluthpatabendi, W M T D Kularatne, Pushpa Wijekoon, Rohan Weerasooriya, Jayasundera Bandara
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...
February 2016: Environmental Geochemistry and Health
Kithsiri Bandara Jayasekara, Dhammika Menike Dissanayake, Ramiah Sivakanesan, Asanga Ranasinghe, Ranawaka Hewage Karunarathna, Gardiye Waligamage Gamini Priyantha Kumara
BACKGROUND: The aim of the study was to identify the epidemiology of chronic kidney disease of uncertain etiology in Sri Lanka. METHODS: A cross-sectional study was carried out by analyzing health statistics, and three cohort studies were conducted (n = 15 630, 3996, and 2809) to analyze the demographic information, age-specific prevalence, etiology, and stage of presentation. We screened 7604 individuals for chronic kidney disease of uncertain etiology. RESULTS: The results showed that the male:female ratio was 2...
2015: Journal of Epidemiology
Tewodros Rango, Marc Jeuland, Herath Manthrithilake, Peter McCornick
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...
June 15, 2015: Science of the Total Environment
Channa Jayasumana, Saranga Fonseka, Ashvin Fernando, Kumudika Jayalath, Mala Amarasinghe, Sisira Siribaddana, Sarath Gunatilake, Priyani Paranagama
Chronic Kidney Disease of unknown etiology (CKDu) has escalated into an epidemic in North Central Province (NCP) and adjacent farming areas in the dry zone of Sri Lanka. Studies have shown that this special type of CKD is a toxic nephropathy and arsenic may play a causative role along with a number of other heavy metals. We investigated the hypothesis that chemical fertilizers and pesticide could be a source of arsenic. 226 samples of Fertilizers and 273 samples of pesticides were collected and analyzed using atomic absorption spectrometry and inductively coupled plasma mass spectrometry for arsenic and other heavy metals in two university laboratories...
2015: SpringerPlus
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