| dc.description.abstract | Concerning the impact of Chronic Kidney Disease of uncertain etiology (CKDu), central
highlands in the wet climatic zone of Sri Lanka are considered to be safe, as CKDu is not
reported among adults. However, being an agricultural area with intensive agrochemical
usage, we hypothesized that there could be exposure-related renal health risks for the
inhabitants. Hence, this study aimed to assess renal health of residential paediatric
communities in this particular region in comparison to an age-matched control group
from the low-country dry climatic zone. Within 12-18 years of age, 596 students (274 boys,
322 girls) from the central highlands of the wet climatic zone, and 488 students (229 boys,
259 girls) from the dry climatic zone participated in this cross-sectional study. Creatinine adjusted median (interquartile range) urinary KIM-1 level of the participants in the wetzone [0.2476(0.002 − 0.664) ng/mgCr] was significantly high (p < 0.0001) compared
to the participants in the dry-zone [0.0709 (0.002-0.232) ng/mgCr]. Participants in wetzone showed significantly high (p = 0.0139) urinary NGAL level [3.562(1.757 − 7.539)
ng/mgCr] compared to the participants in the dry-zone [3.169 (1.602-5.847) ng/mgCr].
Moreover, significant elevation (p = 0.0024) of urinary Albumin to Creatinine Ratio
(ACR) level was observed in participants of the wet-zone [3.012(1.752 − 5.546) mg/g],
comparted to those of the dry-zone [2.589(1.565 − 4.194) mg/g]. The incidences of
albuminuria (ACR ≥ 30 mg/g) were 2.9% and 1.2% among the participants in wet and dry
climatic zones respectively. Significantly elevated urinary NGAL, ACR, and particularly
KIM-1 which is a more reliable indicator of impaired kidney function, reflect preliminary
evidence of a potential risk of subclinical renal injury among the residential paediatric
communities in the central highlands in Sri Lanka. In-depth studies with longitudinal
observations are warranted for characterization of the paediatric renal health risks comprehensively. | |
