Chronic kidney disease of unknown etiology (CKDu) is spreading gradually in Sri Lanka. In the current research, 1,435 well water samples from all 25 districts of Sri Lanka, 91 rice samples, and 84 human urine samples from both CKDu-endemic and non-endemic areas in Sri Lanka were analyzed for arsenic, cadmium, lead, and chromium to detect whether toxic elements could be a cause of CKDu. The liver-type fatty acid binding protein (L-FABP) concentration and arsenic, cadmium, lead, and chromium concentrations of the urine samples were analyzed to determine the relation of L-FABP with arsenic, cadmium, lead, and chromium. High concentrations of arsenic, cadmium, lead, and chromium were not detected in the well water samples from CKDu-endemic areas. Arsenic, cadmium, and lead contents in the rice samples from both CKDu-endemic and non-endemic areas were well below the Codex standard. There were no relationships between the L-FABP concentration and concentrations of arsenic, cadmium, lead, and chromium in urine. In addition, arsenic, cadmium, lead, and chromium concentrations in human urine samples from CKDu-endemic areas were not significantly different from those from non-endemic areas. These findings indicated that arsenic, cadmium, lead, and chromium could not cause CKDu.

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The ingestion of fluoride-contaminated water causes serious health issues in people all over the world. In the current study, the adsorption of fluoride onto chicken bone char (CBC) was investigated as a defluoridation technique. Finer-sized CBC with a diameter of 106–212 µm was used to investigate the fluoride adsorption capacity onto CBC. Results revealed that finer-sized CBC yielded an unusually high fluoride adsorption capacity of 11.2 mg/g at the equilibrium fluoride concentration of 10 mg/L. The study shows that CBC can be utilized in the defluoridation of drinking water and that finer-sized CBC enhances ion exchange to perform a higher adsorption capacity.

Ab s trac t Polpala (Aeroa lanata) is a medicinal plant that is extensively used fo r the treatment of renal disease in Ayurvedic medicine. This preliminary investigation was carried out to evaluate the diuretic effect of the crude aqueous plant extract and high and low molecular mass fractions of this herb, using the hydrated rat assay technique. Possible toxicological effects on renal structure and function , mediated by long term administration of aqueous plant extract was also studied using two concentrations of both fresh and dried plant material , made according to A yurvedic system of medicine in Sri Lanka. Urine output, osmolality and electrolyte excretion were measured to evaluate diuretic activity. Creatinine clearance and histopathological studies were done to evaluate toxicological effects on renal structure and function. Crude aqueous plant extract showed a diuretic activity with marked increase in urine output, urine osmolality and urinary potassium excretion. Low molecular mass fraction of dried plant material showed a Significant diuretic effect while the high molecular fraction did not have the same effect. Investigations also showed that long term administration of the aqueous extract of this plant had no toxicological effects on renal structure and function of rats.

Neonicotinoids are systemic insecticides used since the 1990’s , that possess renal tubular toxicity. We conducted a field-based descriptive study in the North Central Dry-zone of Sri Lanka, where chronic kidney disease (CKD) of unknown etiology has been increasing since the 1990’s. To elucidate the relationship between renal tubular dysfunctions and urinary neonicotinoids concentrations, we collected spot urine samples from15 CKD patients, 15 family members, and 62 neighbors in 2015, analyzed two renal tubular biomarkers, Cystatin-C and L-FABP, quantified seven neonicotinoids and a metabolite N-desmethyl-acetamiprid by LC–MS/MS; and we investigated their symptoms using a questionnaire. Cystatin-C and L-FABP had a positive correlation (p < 0.001). N-Desmethyl-acetamiprid was detected in 92.4% of the urine samples, followed by dinotefuran (17.4%), thiamethoxam (17.4%), clothianidin (9.8%), thiacloprid and imidacloprid. Dinotefuran and thiacloprid have never been registered in Sri Lanka. In High Cystatin-C group (> 70 μg/gCre, n = 7), higher urinary concentration of dinotefuran (p = 0.009), and in Zero Cystatin-C group (< LOQ, n = 7), higher N-desmethyl-acetamiprid (p = 0.013), dinotefuran (p = 0.049), and thiacloprid (p = 0.035), and more complaints of chest pains, stomachache, skin eruption and diarrhea (p < 0.05) were found than in Normal Cystatin-C group (n = 78). Urinary neonicotinoids may be one of the potential risk factors for renal tubular dysfunction in this area.