Geochemistry of Groundwater in the Uva Province, Sri Lanka—Implications for Chronic Kidney Disease of Uncertain Origin

Abstract

The prevalence of chronic kidney disease of uncertain etiology (CKDu) in the Uva Province (UP) of Sri Lanka has received much attention over the past two decades. Many scientists assumed that prolonged consumption of drinking water with high levels of contaminants may be the causative factor. Thus, the prime objective of this study is to develop a binary logistic regression model based on water quality parameters and the prevalence of CKDu to find out the geochemical risk factors that affect the CKDu. For this, 260 groundwater samples were collected following a stratified random sampling method and analyzed for its major cations, anions, and selected trace element contents. In the model, the dichotomous dependent variable defines the availability of CKDu patients, and explanatory variables define groundwater quality parameters. According to the best-fit model, F− and PO43- levels of the groundwater were found to be the geochemical risk factors that were significantly associated with the progression of CKDu in the study area. Furthermore, it was shown that geochemical processes such as dissolution of bedrocks are the causative phenomenon of the enhancement of F− levels in the groundwater sources. It has also been observed that the PO43- concentrations of the groundwater possibly increase because of the intensive application of agrochemicals in addition to geogenic sources. The results of this study can be used by the government authorities in groundwater management and the management of the prevalence of CKDu disease in the study area. Furthermore, the findings of this study will contribute to the policy-makers in Sri Lanka for providing safe drinking water to meet the sustainable development goals (SDGs).

Comment on “Glyphosate and Fluoride in High-Hardness Drinking Water Are Positively Associated with Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka”

“…There is convincing evidence that the combined effect of multiple factors in well water (such as water hardness, increased Ca 2+ and fluoride levels, among others), ,,, including natural geochemical contamination of groundwater − (not agrochemicals or heavy metals), is more closely linked with CKDu than glyphosate or heavy metals. An overenthusiastic title and conclusions without supporting data would mislead the public and falsely perpetuate blame on glyphosate and other pesticides for causing CKDu.…”