title: Diminished disease progression rate in a chronic kidney disease population following the replacement of dietary water source with quality drinking water: A pilot study.
abstract: OBJECTIVE
  Environmental toxin/s is alleged to be the contributory factor for the chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka. The potential of drinking water as a medium for the nephrotoxic agents in the affected subjects has been comprehensively discoursed in the recent past. The present study was aimed to assess the effect of replacing the habitual drinking water on the kidney function of CKDu patients residing in the North Central Province of Sri Lanka: METHODS: An interventional study was carried out to assess the disease progression rate of a CKDu population whose habitual drinking water was replaced by bottled spring water certified by Sri Lanka Standard (SLS) for a period of 18 month along with a population of CKDu patients who continued with their usual drinking water. Kidney function of subjects in both groups were monitored in terms of blood pressure, serum creatinine, serum calcium, serum phosphorus, hemoglobin, estimated glomerular filtration rate and urinary protein at 6 months intervals during the intervention and follow up periods.
  
  
  RESULTS
  Diminished disease progression rate was observed in CKDu patients in the intervention group when compared with the non- intervention group based on serum creatinine, Hb, estimated glomerular filtration rate and urinary protein levels. Extensive interventional studies are required to generalize effect of drinking water on CKDu population.
  
  
  CONCLUSIONS
  The habitual drinking water is likely to be a contributory factor towards the progression of the disease.
authors.affiliation: Department of Biochemistry, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka.
authors.forename: Edirisinghe Arachchige Ranga Iroshanie Edirisinghe
authors.identifier: http://orcid.org/0000-0002-0171-8386
authors.initials: EARIE
authors.lastname: Siriwardhana
authors.affiliation: Department of Biochemistry, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka.
authors.forename: Ponnamperuma Aratchige Jayasumana
authors.initials: PAJ
authors.lastname: Perera
authors.affiliation: Department of Biochemistry, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Ramiah
authors.initials: R
authors.lastname: Sivakanesan
authors.affiliation: Department of Pharmacology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Tilak
authors.initials: T
authors.lastname: Abeysekara
authors.affiliation: Department of Community Medicine, SAITM Faculty of Medicine, Malabe, Sri Lanka.
authors.forename: Danaseela Bandara
authors.initials: DB
authors.lastname: Nugegoda
authors.affiliation: Department of Parasitology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka.
authors.forename: Kosala
authors.identifier: http://orcid.org/0000-0002-4814-6928
authors.initials: K
authors.lastname: Weerakoon
authors.affiliation: Sri Lanka Institute of Nanotechnology, Science and Technology Park, Colombo, Sri Lanka.
authors.forename: Dunusingha Asitha Surandika
authors.identifier: http://orcid.org/0000-0002-6601-6238
authors.initials: DAS
authors.lastname: Siriwardhana
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood / Q000652:urine; D018450:Disease Progression; D004326:Drinking; D060766:Drinking Water / Q000009:adverse effects; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D010865:Pilot Projects; D011507:Proteinuria / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D013188:Sri Lanka; D013997:Time Factors; D014874:Water Pollutants, Chemical / Q000009:adverse effects*; D014881:Water Supply
chemical_list: D015415:Biomarkers; D060766:Drinking Water; D014874:Water Pollutants, Chemical
keywords: Chronic Kidney Disease; Disease Progression; Habitual Drinking Water; Kidney Function