Role of drinking water with high Silica and Strontium in Chronic Kidney Disease: An Exploratory Community-based Study in an Indian Village

Abstract

Background: Ground water is the ultimate and inevitable source of drinking water in rural India. Seepage of earth’s crust elements into drinking water sources may lead to adverse health effects. Media reported unusually high kidney related disorders among the population in Uchapally village of Nellore district, Andhra Pradesh, India. Objective: The objective of the present study was to assess the role of drinking water in chronic kidney disease (CKD). Methods: A community based cross-sectional study was carried out among the population residing in two villages namely Uchapally with reported cases of renal diseases (Village-A; n=52) and Pedarajupalem with no reported cases of renal diseases (Village-B; n=50) from Nellore district, Andhra Pradesh, India. Blood and urine samples were collected to estimate the renal parameters. Glomerular Filtration Rate (GFR) as calculated by Modification of Diet in Renal Disease (MDRD) equation was used to assess the staging of CKD. Results: Majority of subjects in village-A were suffering from different stages of CKD. Blood urea and creatinine, intact parathyroid hormone and alkaline phosphatase levels were significantly (p<0.01) higher among the subjects in village-A. Silicon and Strontium levels in the drinking water samples from village-A were significantly higher as compared to the water samples from Village-B. The subjects from Village-A had a history of prolonged consumption of various non-steroidal anti-inflammatory drugs (NSAIDs). Conclusion: The high prevalence of CKD among the population in village-A could be attributed to the synergistic effect of chronic exposure to silicon and strontium through drinking water and prolonged consumption of NSAIDs.