Potential link between ground water hardness, arsenic content and prevalence of CKDu

Abstract

Highest prevalence of CKDu occurs in the largest rice farming areas in Sri Lanka and it is reported that approximately 99 % of CKDu patients are farmers(1). It was reported that source of drinking water of CKDu patients are obtained from dug wells (92 %) and tube wells (08 %)(2). Age of majority of the CKDu patients are between 30 ? 40 years and they are heavily exposed to agrochemicals as very little attention is given to hazardous effects on human health(2). Our preliminary investigations revealed that significantly higher percentage of CKDu patients (p<0.05) showed spotty pigmentations on their soles and palms. However it was also confirmed that it is different from characteristic pigmentations observed among people in Bangladesh due to chronic arsenic toxicity (fig. 1)(4). This was the main reason to concentrate our work on investigation of arsenic content in urine and hair of CKDu cases(4-6). Analysis of urine and hair of 348 subjects in the study area (CKDu, n=125; controls from endemic area, n = 180; controls from nonendemic area, n = 43) indicated that approximately 72.5 % of CKDu patients had urine arsenic levels > 21 ?g/g creatinine and significantly high concentration of arsenic has been observed in high keratin containing tissues such as hair and nails among the CKDu cases (p<0.05)(5). Analysis of organ samples of deceased CKDu patients from the study area also have shown about ten-fold increase of arsenic in comparison to that of kidneys of an unexposed individual(6).