ISSN: 2577-4360
Authors: Shirani R*, Yang M, Ziming H, Ashraful I, Zhang Y, Chathura R and Thanusha P
Introduction: Despite much research on chronic kidney disease of uncertain etiology (CKDu) in Sri Lanka the etiology and pathogenesis remains obscure. The fluoride level in the ground water in CKDu prevalent area was considered as one of the suspected etiological factor for the disease. Methodology: A review was conducted through MEDLINE and Google Scholar databases for peer reviewed publications on ground water analysis related to CKDu areas globally. Results: Groundwater plays as the primary source of drinking water in these disease prevalent areas. The occurrence of the disease and the fluoride metabolism in the CKDu patients would give much evidence for the correlation. The factors which decide the water intake of a person, and the fluoride level in the ground water are the critical factors for fluoride intake. There are recommended levels of fluoride for each country. The pathogenesis of Fluoride for the renal damage was well described at cellular level changes. It is associated with oxidative stress leading to organelle damage. Conclusion: Therefore, urinary fluoride can be used as an early indicator of CKDu. Further, Fluoride toxicity occurs in combination of heavy metals such as Mg, Mn and As, Pb etc. Although no clear etiological factor was recognized, Fluoride could be considered as a possible etiological factor for CKDu. As preventive measures, provision of fluoride-free drinking water in the affected areas, early detection of fluoride toxicity can be recommended.
Keywords: Fluoride, Etiology Of CKDu; Groundwater; Drinking Water; Heavy Metals; The Role of Water Quality in the Pathogenesis of CKDu with Respect to Fluoride
