ArticleEnvironmental health and preventive medicine2012
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.
Article in Environmental health and preventive medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Heterogeneity in diagnostic criteria for chronic kidney disease of undetermined etiology (CKDu): a systematic review of the literature.BMC nephrology · 2025Pooled it
- Chronic kidney disease of unknown etiology in Sri Lanka.International journal of occupational and environmental health · 2016Pooled it
- CKD of Uncertain Etiology: A Systematic Review.Clinical journal of the American Society of Nephrology : CJASN · 2016Pooled it
- Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations.Environmental health and preventive medicine · 2014Pooled it
- Stage-wise variation in serum C-reactive protein and cardiovascular risk in chronic kidney disease of uncertain etiology among Sri Lankans; a preliminary study.BMC research notes · 2026Article
- Uncovering potential biomarkers for chronic kidney disease of unknown etiology through a network-based bioinformatic approach.Naunyn-Schmiedeberg's archives of pharmacology · 2026Article
- Lanka virus, a Mus booduga-borne orthohantavirus infection-associated febrile illness in Sri Lanka.PLoS neglected tropical diseases · 2025Article
- Systematic Review of Kidney Injury Biomarkers for the Evaluation of CKD of Uncertain Etiology.Kidney international reports · 2024Article
- Heavy metal association with chronic kidney disease of unknown cause in central India-results from a case-control study.BMC nephrology · 2024Article
- Decreasing incidence of hospital diagnosed CKD/CKDu in North Central Province of Sri Lanka: is it related to provision of drinking water reverse osmosis plants?BMC nephrology · 2024Article
- Early Ultrastructural Changes in Biopsies From Patients With Symptomatic CKD of Uncertain Etiology.Kidney international reports · 2023Article
- Factors Associated with Chronic Kidney Disease of Unknown Etiology (CKDu): A Systematic Review.Healthcare (Basel, Switzerland) · 2023Review
- Prevalence of Chronic Kidney Disease of Uncertain Etiology Within Selected Farming Communities in Rural Sri Lanka.Canadian journal of kidney health and disease · 2023Article
- Major and trace elements in rice paddy soils in Sri Lanka with special emphasis on regions with endemic chronic kidney disease of undetermined origin.Environmental geochemistry and health · 2022Article
- A robust, accurate, sensitive LC-MS/MS method to measure indoxyl sulfate, validated for plasma and kidney cells.Biomedical chromatography : BMC · 2022Article
- Two decades of chronic kidney disease of unknown aetiology (CKDu) research: Existing evidence and persistent gaps from epidemiological studies in Sri Lanka.Nephrology (Carlton, Vic.) · 2022Review
- Urinary concentrations of neonicotinoid insecticides were related to renal tubular dysfunction and neuropsychological complaints in Dry-zone of Sri Lanka.Scientific reports · 2021Article
- The Utility of Novel Renal Biomarkers in Assessment of Chronic Kidney Disease of Unknown Etiology (CKDu): A Review.International journal of environmental research and public health · 2020Review
- Does fluoride cause the mysterious chronic kidney disease of multifactorial origin?Environmental geochemistry and health · 2020Review
- Experimental rat model for acute tubular injury induced by high water hardness and high water fluoride: efficacy of primary preventive intervention by distilled water administration.BMC nephrology · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn the North Central Province of Sri Lanka, chronic kidney disease of uncertain etiology (CKDue) has increased markedly over the past 15-20 years.
methodsFrom around 4,700 patients who were followed up, 106 affected patients who visited two local clinics in the endemic area for CKDue on August 10, 2009 and 10 pedigrees of 10 of these cases with familial clustering of CKDue participated in this study. Urine samples, collected from affected patients (n = 106), unaffected relative controls (n = 81), and Japanese controls (n = 50), were analyzed for two tubular markers: α1-microglobulin and N-acetyl-β-D: -glucosaminidase. Urine samples from patients with CKDue stages 1-4 (n = 101) and all the samples from unaffected relatives and Japanese controls were analyzed for urinary cadmium concentration.
resultsUrinary excretion of α1-microglobulin was elevated even in the earliest stage of CKDue compared with its levels in unaffected relative controls. Urinary excretion of N-acetyl-β-D: -glucosaminidase was elevated only in stage 5. In contrast, urinary cadmium excretion was similar in CKDue patients and in the unaffected relative controls, and levels in both these groups were significantly lower than the level in the Japanese controls. All levels were below the threshold level for renal toxicity, indicating the absence of any evidence of cadmium toxicity.
conclusionsThe present study indicates that renal tubular damage occurs in the very early stage of CKDue and demonstrates the existence of familial clustering, suggesting that CKDue is likely to be the outcome of exposure to an unknown nephrotoxin in susceptible subjects in the endemic region.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.