Objective. We examined heat stress symptoms and urine markers of chronic kidney disease (CKDu) in Sri Lanka to assess differences between endemic vs. non-endemic regions and by occupation. Sample and Methods. We assessed a total of 475 villagers. In the endemic region, 293 were agricultural workers and 67 were not working primarily in agriculture. In the non-endemic region, 76 were agricultural workers. Of the residents, 218 were assessed for neutrophil gelatinase-associated lipocalin (NGAL), an early predictor of acute kidney injury, along with urine markers of chronic kidney disease. Results. The mean (sd) age of the sample was 45.2 (12.6), with males comprising 52.7%; 7.2% reported kidney disease (n = 34), and 5.7% reported diabetes (n = 27). The heat stress index (mean (sd)) was highest among agricultural workers in the endemic region (8.05 (5.9)), intermediate in non-agricultural workers in the endemic region (4.61 (4.5)), and lowest among agricultural workers in the non-endemic region (3.85 (3.3)); p < 0.0001. Correlations were higher between NGAL and serum microalbumin in the endemic agricultural worker sample than in the other two samples (Spearman’s r = 0.34 vs. 0.15 and 0.20). Conclusions. Both heat stress symptoms and NGAL values were higher among agricultural workers in endemic CKDu regions. Correlations between NGAL and microalbumin suggested a link between acute kidney injury and chronic kidney disease in the more-exposed sample.
Background: Since early nineties investigators in Sri Lanka have noticed an alarmingly high incidence of a new form of chronic kidney disease of uncertain etiology (CKDu) in North Central Region of the country. The purpose of the present study was to assess the treatment response profile of a selected traditional medicine used for Chronic Kidney Disease of unknown etiology in Sri Lanka.
Methods: A follow-up study was performed with Chronic Kidney Disease of unknown patients receiving a selected traditionalmedicine in Sri Lanka. Socio-demographic characteristics and anthropometric measurements were documented. Blood and urine samples were collected for biochemical analysis. Multistate Markov model was used to estimate rates of transition between stages of chronic diseases.
Results: Anthropometric and biochemical parameters of 96 CKDu patients and 20 normal individuals were recorded in a period of six months. Serum creatinine, urine micro albumin, Albumin creatinine ratio and Systolic Blood pressure values were significantly decreased in the six-month study period. eGFR value was significantly increased over the six-month study period. Positive correlations were identified between ACR-Micro albumin, ACR-BMI and ACR-eGFR while e-GFR-serum creatinine, e-GFR-micro albumin and ACR-serum creatinine showed negative correlations.
Conclusions: A significant improvement in both biochemical and anthropometric parameters were observed among patients who underwent Sri Lankan traditional medicine treatment. Continuous follow up programs are important to improve biochemical and physical parameters as well as their quality of life.
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