Chronic kidney disease of unknown origin in Sri Lanka and its relation to drinking water supplies

Paranagama, D 2014, Chronic kidney disease of unknown origin in Sri Lanka and its relation to drinking water supplies, Doctor of Philosophy (PhD), Civil, Environmental and Chemical Engineering, RMIT University.


Document type: Thesis
Collection: Theses

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Title Chronic kidney disease of unknown origin in Sri Lanka and its relation to drinking water supplies
Author(s) Paranagama, D
Year 2014
Abstract Chronic Kidney Disease (CKD) is a major health concern in North Central Province (NCP) of Sri Lanka. Anuradhapura and Polonnaruwa are the two most affected districts in NCP. Excess fluoride in groundwater used for drinking is suspected to cause CKD. This research was designed to identify possible CKD causative agents in drinking water of NCP. An analytical framework was developed to analyze drinking water sample data collected from shallow wells of CKD patients and non-patients in Anuradhapura and Polonnaruwa districts. Statistical analytical methods included Univariate Analysis of Variance (ANOVA) followed by Dunnett’s T3 post hoc test, Kruskal Wallis (KW) test followed by Mann-Whitney’s post hoc test, Factorial analysis followed by reliability tests and Discriminant analysis.

A secondary data set obtained from CKD endemic and non-endemic areas were also analyzed independently using the same analytical techniques to validate results. Total results indicated that sodium and fluoride combination was the probable factor in drinking water of CKD patients. Sodium and fluoride as a combined factor was non-existent or less significant than magnesium and fluoride combination in non-patients. Even though Cd2+ and As3- were suspected to be causing CKD, As3- was not detected in Anuradhapura and Polonnaruwa samples and Cd2+ was insignificant in Polonnaruwa samples. Rainwater harvesting (RWH) was proposed as a mitigation measure to the CKD endemic areas as an alternative to groundwater supplies. RWH tanks were estimated for eight rainfall stations in Anuradhapura and Polonnaruwa districts, using Mass Curve Method.

For a four member household with average drinking water demand of 6 L/capita/day the rainwater tank sizes estimated varied between 3000 and 5100 L. Minimum runoff surface area estimations required to fill those tanks were between 6 to 18 m2. As such estimated tank sizes were of manageable size and can be applied in Anuradhapura and Polonnaruwa districts at household levels to supply drinking water as an alternative to groundwater sources. Removal of fluoride from drinking water obtained from ground water sources was the other CKD mitigation technique proposed in this research. Lab experiments showed that turmeric powder has fluoride removal capacity of 20% at concentrations between 2- 20mg/L. Langmuir Isotherm better fitted experimental results indicating monolayer adsorption. Intra-particle mass transfer diffusion equation indicated adsorption is governed by diffusion within the pores of the adsorbent. Column experiments showed that Fluoride adsorption by turmeric could be attributed to the processes of ion-binding and ion-exchange between turmeric and fluoride. After column experiments turmeric was regenerated with 1.0M NaOH. With the test results it was concluded that turmeric powder is a potential material for effective removal of fluoride.
Degree Doctor of Philosophy (PhD)
Institution RMIT University
School, Department or Centre Civil, Environmental and Chemical Engineering
Keyword(s) Chronic Kidney Disease (CKD)
North Central province of Sri Lanka
ANOVA
Kruskal Wallis
Discriminant analysis
Factorial analysis.
Rainwater harvesting
Absorption
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