Urinary Concentrations of Neonicotinoid Insecticides in Chronic Kidney Disease Patients, Their Family Members and Others in Dry-Zone of Sri Lanka

Abstract

The growing worldwide prevalence of chronic kidney disease of unknown etiology (CKDu) has been reported since the 1990’s. Neonicotinoids are systemic insecticides used since 1990’s, which may cause renal dysfunction, but the effect on the urinary concentration was unknown. We conducted a field-based case-control study in the North Central Dry-zone of Sri Lanka where CKDu was prevailing. We collected spot urine samples from15 CKD patients, 15 CKD family members, and 62 neighbors in May and December 2015, analyzed seven neonicotinoids and a metabolite by LC-ESI/MS/MS, in addition to two biomarkers of renal tubule activity, Cystatin-C and L-FABP. We also investigated their symptoms using a questionnaire. In CKD patients, urine Cystatin-C and L-FABP were significantly higher compared to non-CKD participants; and they complained of finger tremor, fever, and abnormal behavior more. Among neonicotinoids, N-desmethyl-acetamiprid was detected at the highest rate in 92.4 %, followed by thiamethoxam in 17.4%. Dinotefuran and thiacloprid that was not registered since 2015 in Sri Lanka were detected in 17.4%, 3.3%, respectively. In the participants whose urine Cystatin-C was in higher half, N-desmethyl-acetamiprid was significantly less than others. The urine neonicotinoid levels in CKD patients with compromised tubular function doesn’t seem to reflect their level of exposure.