Evidence map›Paper›PMID 32883252›Full record

ArticleBMC nephrology2020

Evidence of selected nephrotoxic elements in Sri Lankan human autopsy bone samples of patients with CKDu and controls.

Thalarabe Bulathge Ananda Jayalal, Sanath Thushara Chamakara Mahawithanage, Senanayaka Mudiyanselage Harshana Mahendra Kumara Senanayaka, Prasanna Bandara Dassanayaka

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nephrology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 29% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Article
  6. Review
  7. Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 1 country.

Thalarabe Bulathge Ananda JayalalDeputy Director-General Environmental Health Occupational Health and Food safety, Ministry of Health, Nutrition and Indigenous Medicine, Colombo, Sri Lanka.
Sanath Thushara Chamakara MahawithanageDepartment of Biochemistry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Colombo, Sri Lanka. sanath.mahawithanage@sjp.ac.lk.ORCID 0000-0001-5013-315X
Senanayaka Mudiyanselage Harshana Mahendra Kumara SenanayakaTeaching Hospital, Anuradhapura, Sri Lanka.
Prasanna Bandara DassanayakaColombo South Teaching Hospital, Kalubowila, Sri Lanka.
Colombo North Teaching Hospital · LKMinistry of Health, Nutrition and Indigenous Medicine · LKTeaching Hospital Kandy · LKUniversity of Sri Jayewardenepura · LK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis article describes the analysis and interpretation of data relating to the presence of cadmium, lead, mercury and fluoride in human bone samples obtained from cadavers of patients dying of Chronic Kidney Disease of uncertain aetiology (CKDu) in a case-control study, which the authors believe to be the first in Sri Lanka.

methodsThis is a case-control study comparing selected nephrotoxins levels in autopsy samples of bones from persons confirmed to have died of CKDu, and who had lived in a CKDu hotspot and controls with no history of abnormal kidney functions who had lived in areas having a low prevalence of CKDu.

resultsThe average age at death of the cases was 59.6 ± 15.1 (±SD), while that for controls was 58.0 ± 19.3 (±SD) years with no significant statistical difference. Calcium adjusted bone lead and bone fluoride levels were significantly higher among CKDu cases (n = 14) than those of controls (n = 33). Further, younger and older clusters of CKDu cases can be differentiated when the calcium adjusted lead content was considered. Younger patients reported higher lead content compared to the older group. Cadmium and mercury content did not show a remarkable difference among cases and controls.

conclusionsOur results show a significant accumulation of lead in bone tissue in persons who have died of CKDu which indicates a higher chronic exposure of the CKDu victims, to lead. Fluoride content in the bones of cases is also significantly high. The results indicate that a gradual reduction of glomerular filtration rate (GFR) may have occurred with the chronic exposure to lead. At a certain point of the threshold of low GFR, excretion of fluoride may be impaired, since the main excretory pathway of fluoride is via the kidneys. Fluoride accumulation in blood in turn may exacerbate nephrotoxicity, triggering a synergistic cascade of events which may lead to a further deterioration in the GFR. The extremely high fluoride content detected suggests a cumulative effect in people exposed to comparatively higher fluoride levels, most probably from drinking water.

Indexed as

AdultAgedAge FactorsAgricultureBone and BonesCadmiumCalciumCase-Control StudiesDisease HotspotEnvironmental ExposureFemaleFluoridesHumansLeadMaleMercuryCadmiumCalciumFluoridesLeadMercuryChronic kidney disease; cadmiumCINACCKDuFluorideLeadMercuryNephrotoxinsSri Lanka

Identifiers

PMID32883252
PMCPMC7470610
OpenAlexW3081891764

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.