Since about 15 years selected areas in Sri Lanka show unusually high occurrences of serious chronic kidney disease (CKD) with about 60000 patients and 20000 mortalities in a population of 20 million inhabitants. In affected regions in the northern parts of the island kidney damages were mostly described as ‘tubulo-interstitial’. This histological type is common with toxicological causes and indicates that environmental influences have to be investigated more closely. Polluted water can play a central role in this mechanism because it establishes direct contact with kidneys via consumption. Increased use of groundwaters with possible increased trace elements such as arsenic or cadmium are foreseen for closer investigation. Water from affected regions will also be analysed for organic contaminants such as pesticides or algae toxins and their metabolites. In collaboration with colleagues from Sri Lanka and with the World Health Organization (WHO), the International Society of Nephrology (ISN) and the International Association of Hydrogeologists (IAH), we plan to combine distribution patterns of the disease, water chemical compositions and nephrological investigations. This interdisciplinary approach will help to establish cause-effect-relationships and helps with plans to reduce the spread of the disease.
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https://germany.iah.org/news/nephrology-meets-hydrogeology