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Agrochemicals and CKDu



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I appreciate very much Dr. Channa Jayasumane’s (CJ) quick response to my letter titled ‘Docs and banning of agrochemicals’ which appeared in The Island of 10th Feb.. But, CJ has not indicated what agrochemical/s he was referring in the news item of The Island, of 31 Jan. which was attributed to CJ.


CKDu or CRF


CJ says that nowhere in the medical world is Chronic Kidney Disease (CKDu) is called Chronic Renal Failure (CRF). A word related to Kidney is Renal, (e.g. the artery which supplies blood to the kidney is called Renal Artery) and the kidney disease is more specifically indicated by the word failure. Hence, Chronic Kidney Disease (CKD) can be called Chronic Renal Failure. In fact, if CJ surfs the Internet and looks for CRF he will find thousands of entries.


WHO Report and CKDu


It is interesting to note that CJ indicates that there are fundamental flaws in the design, analysis, reporting and conclusions of the WHO study. If CJ insists that WHO report investigation and Evaluation of Chronic Kidney Disease of Uncertain Aetiology in Sri Lanka’ with all these flaws has made any conclusions, could he please indicate what these conclusions are for the benefit of the general public. Because in the final report of the WHO I am unable to find any conclusions except a discussion in pages 16 and 17 of the report.


Water Hardness and CKDU:


According to a paper on "…Potential Link between Ground Water Hardness, Arsenic and Prevalence of CKDu" highlighting a research study carried out by a number of scientists including CJ, hardness of water is highest in the North and most areas of NCP. However, there are no CKD patients reported from the North., although agrochemicals are used to a considerable extent. The number of CKDu patients by 2010, according to registries from MOH offices in CKDU endemic areas, in the 23 DS divisions in Anurdhapura district is given below.


No. of DS Divisions with more than 1000-2800 CKDU patients - 3


No. of DS divisions with CKDU patients 100-1000 - 5


No. of DS divisions with CKDU patients <100 - 15


Anuradhapura is an agricultural district where farmers use agrochemicals in the cultivation of upland and lowland. The water in this district is hard, but as given in the data above, the number of CKDU patients is not widely distributed in the province. If CJs theory is correct, 15 DS divisions where agrochemicals are used extensively and where hard water is found the number of CKDU patients must be much more than what is reported.


In Annexure 3 of the report on CKDu, submitted by the officials committee appointed by the Cabinet Sub Committee in 2012, the average hardness in water from Nikawewa, an endemic area, is 174.89 mg/l. In Hambantota (a non-endemic area) the average hardness is 261 mg/l. In both areas agrochemicals are used, perhaps more in Hambantota, but they are not endemic areas. Thus hardness of water and agrochemicals appear to be not key factors responsible for CKDu.


In view of these observations it is not possible to accept CJ’s theory that agrochemicals and water hardness are solely responsible for CKDU. Perhaps CJ may be aware that there are hundreds of agrochemicals used in the country. Hence, it would be much better if CJ can specify what the agrochemical/s is/are rather than merely saying agrochemicals are responsible for CKDU.


CJ has requested me to visit the villages in Mahiyanganaya and Giradurukotte and feel the taste and hardness of water without misleading readers from Colombo. I have visited most of the CKDU affected areas including those in Nikawewa and Polpithigama and tasted the water there during my stay in Anuradhapura over a period of five years, when I was attached to the Faculty of Agriculture of the University of Rajarata as Professor of Soils and Water Resources


As I mentioned in my note published in the Island, it is very important that scientists/professionals refrain from citing unconfirmed /unscientific views/ideas which tend to give wrong information to the general public and to policy makers.


Dr.C.S. Weeraratna


csweera@sltnet.lk


 
 
 
 
 
 
 
 
 
 
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