Evidence map›Paper›PMID 38085354›Full record

ArticlePediatric nephrology (Berlin, Germany)2024

Environmental fluoride exposure and implications on potential pediatric kidney health risks: an approach with urinary biomarkers.

T D K S C Gunasekara, P Mangala C S De Silva, E P S Chandana, Sudheera Jayasinghe, Chula Herath, Sisira Siribaddana, Nishad Jayasundara

Abstract read
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In one paragraph

Article in Pediatric nephrology (Berlin, Germany), 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.7field-weighted citation impact, top 32% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. 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

7 authors at 4 institutions in 2 countries.

T D K S C GunasekaraDepartment of Zoology, Faculty of Science, University of Ruhuna, Matara, 81000, Sri Lanka.ORCID 0000-0002-3095-6164
P Mangala C S De SilvaDepartment of Zoology, Faculty of Science, University of Ruhuna, Matara, 81000, Sri Lanka. chathura@zoo.ruh.ac.lk.ORCID 0000-0002-1927-6512
E P S ChandanaDepartment of Biosystems Technology, Faculty of Technology, University of Ruhuna, Matara, 81000, Sri Lanka.ORCID 0000-0001-8113-7735
Sudheera JayasingheDepartment of Pharmacology, Faculty of Medicine, University of Ruhuna, Galle, 80000, Sri Lanka.ORCID 0000-0003-3506-9908
Chula HerathDepartment of Nephrology, Sri Jayewardenepura General Hospital, Nugegoda, 10250, Sri Lanka.ORCID 0000-0002-2901-4866
Sisira SiribaddanaDepartment of Medicine, Faculty of Medicine & Allied Sciences, Rajarata University, Saliyapura, 50008, Sri Lanka.ORCID 0000-0001-5821-2557
Nishad JayasundaraNicholas School of the Environment, Duke University, Durham, NC, 27708, USA.ORCID 0000-0003-2485-6893
University of Ruhuna · LKDuke University · USRajarata University of Sri Lanka · LKUniversity of Sri Jayewardenepura · LK

Funding

Accelerating Higher Education Expansion and Development (AHEAD) AHEAD DOR 02/40.
6 · The paper itself

Abstract

backgroundEnvironmental fluoride exposure at elevated levels is potentially linked to kidney injury, and may contribute to chronic kidney disease of uncertain etiology (CKDu) as a risk factor. However, this link remains unclear, and examining the risk of kidney damage from early life fluoride exposure may provide important insights. Hence, this study aimed to investigate associations of fluoride exposure with pediatric kidney health in CKDu impacted and unimpacted communities in Sri Lanka.

methodsConsidering the geographical variations in environmental fluoride, climate, and prevalence of CKDu, four study groups were established within selected education zones in CKDu-endemic dry zone regions (D-En), and CKDu-nonendemic regions within the dry (D-NE), wet (W-NE), and intermediate (I-NE) climatic zones. The study population included 922 school students (11-18 years of age). Participants in each group were divided into four subgroups based on quartiles of respective urinary fluoride (UF) distribution for comparison of urinary kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and albumin-creatinine ratio (ACR).

resultsUF levels in participants particularly in CKDu endemic dry zone regions were significantly high compared to the other regions. Significantly high median urinary NGAL (in D-NE) and ACR (in D-EN, and W-NE) levels were observed in subgroups of higher UF quartiles. Albuminuria was not particularly identified in subjects with high UF excretion. Urinary KIM-1 showed no significant variation across the UF quartile subgroups. Linear regression identified weak associations of UF with kidney injury biomarkers.

conclusionsFluoride exposure is particularly high in CKDu-endemic dry zone communities. As implied by kidney injury biomarkers, a strong link between fluoride exposure and pediatric kidney health was not evident at the observed exposure levels in the study regions.

Indexed as

FluoridesRenal Insufficiency, ChronicBiomarkersChildHumansKidneyLipocalin-2BiomarkersFluoridesLipocalin-2BiomarkersFluorideKidney injuryPediatricSri Lanka

Identifiers

PMID38085354
OpenAlexW4389626424

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Registered trials

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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.