ReviewEnvironmental geochemistry and health2019
Chronic kidney disease of unknown aetiology in Sri Lanka and the exposure to environmental chemicals: a review of literature.
Review in Environmental geochemistry and health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
What it found
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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.
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Who cites it
18 citing papers in PubMed.
- A Whole-Exome Sequencing-Based Exploration of Chronic Kidney Disease of Unknown Etiology (CKDu) in an Endemic Population in Sri Lanka.International journal of molecular sciences · 2026Article
- Oral microbiome alterations and their association with long-term heavy metal exposure and early health effects.Journal of oral microbiology · 2026Article
- The silent epidemic of CKDu: advances, challenges, and strategies for sustainable eradication-a narrative review.Clinical and experimental nephrology · 2025Review
- Chronic Kidney Disease of Unknown Etiology: A Global Health Threat in Rural Agricultural Communities-Prevalence, Suspected Causes, Mechanisms, and Prevention Strategies.Pathophysiology : the official journal of the International Society for Pathophysiology · 2024Review
- Exposome and Metabolome Analysis of Sugarcane Workers Reveals Predictors of Kidney Injury.Kidney international reports · 2024Article
- Glyphosate and fluoride in high-hardness drinking water are positively associated with chronic kidney disease of unknown etiology (CKDu) in Sri Lanka.Environmental science & technology letters · 2023Article
- The association between urinary metals/metalloids and chronic kidney disease among general adults in Wuhan, China.Scientific reports · 2023Article
- Renoprotective and Oxidative Stress-Modulating Effects of Taxifolin against Cadmium-Induced Nephrotoxicity in Mice.Life (Basel, Switzerland) · 2022Article
- Environmental metal exposures and kidney function of Guatemalan sugarcane workers.Journal of exposure science & environmental epidemiology · 2022Article
- RETRACTED: Neuroprotective effect of sodium alginate against chromium-induced brain damage in rats.PloS one · 2022Article
- Sugarcane Workweek Study: Risk Factors for Daily Changes in Creatinine.Kidney international reports · 2021Article
- Article
- Lead (Pb) exposure and heart failure risk.Environmental science and pollution research international · 2021Review
- Development of a sensitive direct injection LC-MS/MS method for the detection of glyphosate and aminomethylphosphonic acid (AMPA) in hard waters.Analytical and bioanalytical chemistry · 2021Article
- Associations among Heavy Metals and Proteinuria and Chronic Kidney Disease.Diagnostics (Basel, Switzerland) · 2021Article
- Renal tubular injury induced by glyphosate combined with hard water: the role of cytosolic phospholipase A2.Annals of translational medicine · 2021Article
- The water chemistry and microbiome of household wells in Medawachchiya, Sri Lanka, an area with high prevalence of chronic kidney disease of unknown origin (CKDu).Scientific reports · 2020Article
- Exposure of patients with chronic kidney disease on dialysis to pesticides.Jornal brasileiro de nefrologiaArticle
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Chronic kidney disease of unknown aetiology (CKDu) has emerged as a serious health issue in Sri Lanka. The disease has been recorded in the North Central Province of the country. While studies have elicited many hypotheses concerning the pathogenicity of CKDu, none adequately explains the cause of CKDu and the measures needed to minimise its occurrence. Nephrotoxic heavy metal (oid)s such as cadmium, arsenic, lead, and chromium are present in biological samples of people from endemic areas. This review appraises evidence on the effects of long-term exposure to low concentration of nephrotoxic heavy metals, which could be the principal cause of CKDu. Although a considerable variation exists in metal concentrations in patients' blood and urine, higher levels of heavy metals were consistently observed in affected areas. This review finds that the populations in the endemic areas are exposed to heavy metal (oid)s at low concentrations, which are considered as safe levels; nevertheless, it influences the incidence of CKDu. Recent global studies on chronic kidney disease (CKD) revealed a low concentration of heavy metals in diseased patients. Research findings indicated that CKDu patients in Sri Lanka demonstrated similar blood levels of Cd, Pb, and higher concentrations of Cr than that have been reported globally. Further studies on the influence of combinations of nephrotoxic heavy metals at low concentrations on reduced glomerular filtration rate and other renal biomarkers could explain CKDu pathogenicity.
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Registered trials
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