Area Of Chronic Kidney Disease Research Articles

Identification of Novel Rodent-Borne Orthohantaviruses in an Endemic Area of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka.

We reported the genetic evidence of circulating hantaviruses from small mammals captured in a chronic kidney disease of unknown etiology (CKDu) hotspot area of Sri Lanka. The high seroprevalence of anti-hantavirus antibodies against Thailand orthohantavirus (THAIV) has been reported among CKDu patients and rodents in Sri Lankan CKDu hotspots. We captured 116 small mammals from CKDu endemic regions in the Polonnaruwa District of Sri Lanka. Seven animals (five out of 11 Mus booduga and two out of 99 Rattus rattus) were PCR-positive for the hantavirus. A rat-borne sequence was grouped with a THAIV-like Anjozorobe virus. In contrast, Mus-borne sequences belonged to the THAIV lineage, suggesting a novel orthohantavirus species according to the phylogenetic analyses and whole-genome comparisons. Our genetic evidence indicates the presence of two THAIV-related viruses circulating in this CKDu endemic area, suggesting a basis for further investigations to identify the infectious virus in patients with CKDu and the CKDu induction mechanism of these viruses.

Groundwater quality and antibiotic resistance of coliform bacteria in Wilgamuwa, an area of Chronic Kidney Disease of unknown etiology (CKDu) in Sri Lanka

The Sri Lankan Journal of Infectious Diseases (SLJID) is an open access, peer-reviewed, biannual journal published by the Sri Lankan Society for Microbiology (SSM). The Journal considers articles from all professional disciplines involved in the field of infectious diseases. The Journal has been in publication since 2011, is included in the DOAJ since 2018 and is a member of COPE since 2021. The SLJID practices a double-blind peer review policy. From 2022, the SLJID publishes accepted manuscripts online immediately after copy-editing, enabling rapid dissemination of scientific knowledge. The published articles are subsequently compiled into two issues in April and October. The SLJID does not charge any article processing or publication fee.

Trust, Conflict, and Engagement in Occupational Health: North American Epidemiologists Conduct Occupational Study in Communities Affected by Chronic Kidney Disease of Unknown Origin (CKDu).

Science has been used as a tool of colonialism, and aspects of science privilege researchers in the global North (USA and Europe). The environmental justice and worker health movements in the USA and globally have influenced aspects of how occupational and environmental health research is conceived and conducted so that it is more equitable. This review provides a case example of research in the area of chronic kidney disease of unknown origin (CKDu). In the present work, the author describes aspects of community-based participatory research and anti-colonial research that influence a current occupational epidemiology study of CKDu in Mesoamerica among workers in agriculture and non-agricultural industries. The research includes investigators from numerous countries in the global North and South and funding from the US government and corporations. The role of industry in science and the misuse of science by corporate interests remain substantial threats to research integrity. The ability of researchers to navigate potentially conflicting interests with industry and workers, and establish trust within and outside the scientific community, is essential for sustained engagement in longitudinal studies. Trust is about human relationships. It takes time and effort to build and is essential for creating equitable, empowering research relationships.

Urinary Proteomics and Precision Medicine for Chronic Kidney Disease: Current Status and Future Perspectives.

Precision medicine is since long an ongoing refinement of classical medicine, integrating improved and more detailed pathophysiological understanding with rapid technological advances. In the heterogenous area of chronic kidney disease there seems to be a high potential for the improvement in treatment and prognosis for several causes, with new technologies under development, that are yet to be introduced in clinical practice. As in other medical disciplines, investigation of abundant peptide patterns (proteomics) has gained recent interest. Especially relevant for kidney disease, urinary proteomics may provide both improved diagnosis and, as reviewed here, also holds promise for personalized treatment in the future. So far, capillary electrophoresis coupled to mass spectrometry (CE-MS) is the most widely applied technique, and in addition to several cross-sectional and cohort studies, there is even an ongoing randomized controlled trial that will soon report on the concept used as a method of personalizing treatment. In addition, there is hope that urinary proteomics can turn into a "liquid biopsy," replacing the invasive diagnostic procedure. The next couple of years will provide more answers on the topic.

Chemical Speciation Comparison of Drinking Water in North Central Province: An Affected Area of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka

Chronic Kidney Disease of Unknown Etiology (CKDu) is an increasing health issue in Sri Lanka. It is prominent in the North Central Province (NCP), Sri Lanka. This study mainly focuses on Chemical speciation modeling of drinking water in Padaviya, Madawachchiya, Kebethigollewa, Ruwanpura and Nuwaragampalatha central as affected areas in the NCP and Ampara as the reference area of CKDu. Chemical speciation is important for understanding bioavailability, chemical toxicity and environmental fate. Concentrations of major elements in water bodies were analysed and then how chemical speciation change according to the temperature, pH and ionic strength in water bodies were determined. Concentration of Ca2+, Mg2+, Fe2+, Cd2+, Cr3+, Cu2+, Mn2+, Ni2+, Zn2+, Pb2+, Al3+ and dissolved PO43-, SO42-, F-, CO32- and NO3- were used for chemical speciation modelling of drinking water in Ampara and affected areas. Visual MINTEQ version 3.0 software was used for the determination of the species distribution. Temperature varied from 25˚C to 32˚C and pH varied from 5.0 to 8.0. Among the metal ions considered above, only chemical species of Pb2+, Al3+, Cu2+ , Cr3+ and Cd2+ showed higher variations with pH and temperature change. AlF2+, AlF3 and AlF2+ species were formed only in affected areas. Ionic strength changed from 0.001 mol/kg to 0.01 mol/kg and the chemical species distribution of drinking water was also obtained from the software. The percentage of total concentration of Pb2+, Pb(OH)+, Al(OH)3, Al(OH)4- and Fe2+ changed slightly. According to the results obtained, there can be formation of some species Al3+, Cu2+, Cr3+ and Cd2+with the variations of the temperature and pH, which may have an effect on CKDu. Formations of different species were higher with the pH change than the temperature change. Different species which were formed mainly with F- ion in affected areas may also have some significant effect on CKDu. Keywords: Chronic kidney disease, Chemical speciation, Temperature, pH, Ionic strength

Proceedings From the Symposium on Kidney Disease in Older People: Royal Society of Medicine, London, January 19, 2017.

People are living longer. On the whole, they have healthier lives and many of the problems previously seen at a younger age now appear in their later years. Kidneys, like other organs, age, and kidney disease in the aged is a prime example. In the United Kingdom, as in other developed countries, the prevalence of end stage kidney disease is highest in the 70- to 79-year-old age group. There are many older people who require renal replacement and are now considered for dialysis. While older patients with end-stage renal disease invariably aspire for a better quality of life, this needs a specialized approach and management. In January 2017, the Royal Society of Medicine held a seminar in London on “Kidney Disease in Older People” with presentations from a multidisciplinary body of experts speaking on various aspects of kidney problems in this age group and its management. The objectives were to increase awareness and improve the understanding of nephrology in the context of geriatric medicine but also geriatrics in its interface with nephrology, especially in the area of chronic kidney disease.

A comparison between MALDI-MS and CE-MS data for biomarker assessment in chronic kidney diseases

Non-invasive detection of diseases, based on urinary proteomics, is becoming an increasingly important area of research, especially in the area of chronic kidney disease (CKD). Different platforms have been used in independent studies, mostly capillary-electrophoresis coupled ESI-MS (CE-MS), liquid chromatography coupled mass spectrometry, and matrix-assisted laser desorption/ionization mass spectrometry (MALDI-MS). We have compared the performance of CE-MS with MALDI-MS in detecting CKD, based on a cohort of 137 urine samples (62 cases and 75 controls). Data cross-talk between the two platforms was established for the comparison of detected biomarkers. The results demonstrate superior performance of the CE-MS approach in terms of peptide resolution and obtained disease prediction accuracy rates. However, the data also demonstrate the ability of the MALDI-MS approach to separate CKD patients from controls, at slightly reduced accuracy, but expected reduced cost and time. As a consequence, a practical approach can be foreseen where MALDI-MS is employed as an inexpensive, fast, and robust screening tool to detect probable CKD. In a second step, high resolution CE-MS could be used in those patients only that scored negative for CKD in the MALDI-MS analysis, reducing costs and time of such a program.

The Economics of Home Dialysis: Acting for the Individual While Planning Responsibly for the Population

Traditional medical education paradigms tend not to focus on health economics and economic evaluation. This has led to a culture in which bedside clinicians simply allocate health care resources made available to them, with often minimal input as to what these resources are at the population or health care system level. Life sustaining chronic dialysis therapies for end-stage renal disease are heterogeneous in terms of health care costs and the quality of life provided to patients receiving them. From the traditional clinician's perspective, they may be considered equivalent because there are no well-designed randomized control trials establishing the superiority of one particular dialysis modality in terms of all-cause mortality or cardiovascular events. The intent of this review is to provide clinicians practicing in the area of chronic kidney disease some insights into the concepts of economic evaluation and how it may be integrated into clinical decision making at a programmatic level while not compromising individual patient care at the bedside. An epidemiologic perspective will be used to help frame how the implementation of home dialysis modalities vary depending on local health policies in place. Lessons learned by regional nephrology care systems may be readily transferable to other jurisdictions in augmenting the uptake of home dialysis modalities where they are dwindling or struggling to grow. A high-level understanding of economic data in this area may help influence health policy in the direction of the most efficient provision of dialysis to patients while not adversely affecting their quality of life or health outcomes.

KDOQI US Commentary on the KDIGO Clinical Practice Guideline for the Prevention, Diagnosis, Evaluation, and Treatment of Hepatitis C in CKD

KDIGO (Kidney Disease: Improving Global Outcomes) is an international initiative with a key mission of developing clinical practice guidelines in the area of chronic kidney disease (CKD). KDIGO recently published evidence-based clinical practice guidelines for the prevention, diagnosis, evaluation, and treatment of hepatitis C virus infection in individuals with CKD. The process of adaptation of international guidelines is an important task that, although guided by general principles, needs to be individualized for each region and country. Therefore, the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative (KDOQI) convened a multidisciplinary group to comment on the application and implementation of the KDIGO guidelines for patients with CKD in the United States. This commentary summarizes the process undertaken by this group in considering the guidelines in the context of health care delivery in the United States. Guideline statements are presented, followed by a succinct discussion and annotation of the rationale for the statements. Research recommendations that are of particular interest to the United States are then summarized to highlight future areas of inquiry that would enable updating of the guidelines.