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Possible links between groundwater geochemistry and chronic kidney disease of unknown etiology (CKDu): an investigation from the Ginnoruwa region in Sri Lanka

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Abstract

Since at least two decades, Chronic Kidney Disease of Uncertain Etiology (CKDu) has become an increasingly discussed health issue in Sri Lanka and as well as in other tropical regions. Areas that are particularly affected with the disease are mostly located in the dry zone of Sri Lanka. The disease is more prominent among communities that consume groundwater as their main source of drinking water. Hydrogeochemical investigations were carried out in the Ginnoruwa area, a known hotspot of CKDu. It revealed possible links between drinking water chemistry and the spreading of the disease. This work compares hydrogeochemical data of drinking water sources of wells whose consumers are affected by CKDu and other nearby wells whose consumers were not affected by the disease. A total of 63 groundwater samples were collected from selected wells. About one-third of these samples (i.e., 19) were collected from wells used by CKDu patients. Significantly higher values of pH, total hardness, electrical conductivity, Ca2+, Mg2+, F−, Cl−, PO43−, and SO42− were found in wells that were used by CKDu patients. Mean contents of Na+, Ca2+, and Mg2+ in CKDu affected wells were 33.8 mg/L, 30.1 mg/L, and 14.9 mg/L, respectively, compared to 23.1 mg/L, 26.7 mg/L, and 9.65 mg/L in non-CKDu wells. Differences in major ion geochemistry in groundwaters are possibly governed by variable time periods of water storage in fractured hard rock aquifers in this region. Hydrogeochemical parameters were statistically compared by a Mann–Whitney U test and indicated significant differences in total dissolved solids (TDS) (p = 0.016), SO42− (p = 0.005), PO43− (p = 0.030), F− (p = 0.048), Na+ (p = 0.008), and Mg2+(p = 0.008) between non-CKDu and CKDu wells at p = 0.050 level. Other suspected solutes such as nephrotoxic trace elements including As, Cd, and Pb were similar in both types of wells. They were also lower than the accepted guideline limits of the World Health Organization (WHO). Results of this study suggest that fluoride in drinking water in combination with water hardness may be one of the responsible factors for kidney damage and progression of the disease. This may be particularly the case when elevated amounts of Mg2+ are present in hard groundwater.

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Acknowledgements

This study was supported by the National Research Council (NRC) Research Grant (TO 14–05) offered to Rohana Chandrajith and partly supported by the German Federal Ministry of Education and Research (BMBF) (Project Sri-Kid-H2O with Grant Number 01DP17042). Rohana Chandrajith and Johannes Barth also acknowledge the fellowship given to Rohana Chandrajith from Alexander von Humboldt Foundation, Germany during the writing stage of this paper.

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Authors and Affiliations

  1. Department of Geology, Faculty of Science, University of Peradeniya, Peradeniya, Sri Lanka

    Shyamalie Balasooriya, Harshaka Munasinghe, Saranga Diyabalanage & Rohana Chandrajith

  2. Department of Botany, Open University of Sri Lanka, Nawala, Nugegoda, Sri Lanka

    A. T. Herath

  3. Department of Chemistry, Faculty of Science, University of Peradeniya, Peradeniya, Sri Lanka

    O. A. Ileperuma

  4. Sri Lanka Development Initiative, International Water Management Institute (IWMI), Battaramulla, Sri Lanka

    Herath Manthrithilake

  5. Institute of Pathology, Department of Nephropathology, Friedrich-Alexander Universität (FAU) Erlangen-Nürnberg, Krankenhausstr. 8-10, 91054, Erlangen, Germany

    Christoph Daniel & Kerstin Amann

  6. Environmental Analytical Chemistry, Center for Applied Geosciences, Eberhard-Karls-University Tübingen, Hoelderlinstr. 12, 72074, Tübingen, Germany

    Christian Zwiener

  7. Department of Geography and Geosciences, GeoZentrum Nordbayern, Friedrich-Alexander-Univestiät Erlangen- Nürnberg, Schlossgarten 5, 91054, Erlangen, Germany

    Johannes A. C. Barth

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  1. Shyamalie Balasooriya
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Balasooriya, S., Munasinghe, H., Herath, A.T. et al. Possible links between groundwater geochemistry and chronic kidney disease of unknown etiology (CKDu): an investigation from the Ginnoruwa region in Sri Lanka. Expo Health 12, 823–834 (2020). https://doi.org/10.1007/s12403-019-00340-w

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