ArticleCureus2026
Comparative Physicochemical Analysis of Reverse Osmosis-Treated Water and Natural Drinking Water Used by Patients With Chronic Kidney Disease of Unknown Etiology.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundChronic kidney disease of unknown etiology (CKDu) is increasingly recognized in environmentally vulnerable regions where conventional causes do not fully explain disease burden. Drinking-water quality has been proposed as a relevant exposure. This study compared reverse osmosis-treated water and natural drinking water used in a CKDu-affected locality.
methodsThis exploratory comparative analytical observational study with a case-control framework was conducted in Kanchipuram, India, from December 2024 to October 2025. A total of 52 participants were included: 26 (50.0%) with CKDu and 26 (50.0%) non-CKDu controls. One participant-linked drinking-water sample was collected from each subject. Samples were analyzed for pH, total dissolved solids (TDS), sodium, potassium, anion gap, cadmium, copper, lead, zinc, and fluoride.
resultsReverse osmosis-treated water showed markedly lower TDS than natural drinking water (151.03 ± 18.4 vs 662.63 ± 72.8 mg/L, p < 0.001). Cadmium, copper, lead, zinc, and fluoride were also significantly lower in reverse osmosis-treated water (all p < 0.001). pH differed slightly, but both groups remained near neutral. Sodium, potassium, and anion gap showed no significant differences.
conclusionReverse osmosis-treated water and natural drinking water were chemically distinct exposures. The difference was driven mainly by TDS and trace-contaminant burden rather than routine electrolytes. These findings should be interpreted as exploratory and hypothesis-generating and support the relevance of local hydrochemical exposure in CKDu-affected settings.
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