Investigator(s)
| WHO Technical Officer |
Chatura Rasika Wijesundara WHO Sri Lanka Chatura Rasika Wijesundara 
|
| Principal Investigator |
Thilanga Ruwanpathirana Epidemiology Unit, Ministry of Health Thilanga Ruwanpathirana
|
Title(s) and abstract
| Scientific title | A prospective cohort study on environmental and behavioral risk factors for declining kidney functions: Fourth Annual Survey |
| Public title | A prospective cohort study on environmental and behavioral risk factors for declining kidney functions: Fourth Annual Survey |
| Background | Chronic kidney disease of unknown aetiology (CKDu) was first identified in the early 1990s among paddy farmers of the North-Central province in Sri Lanka. A similar disease also emerged from agricultural communities in the Mesoamerican countries and in South India. Though several hypotheses on risk factors have been put forward the most appropriate epidemiological study design, which is the prospective cohort design was not followed by researchers. In this backdrop, the London School of Hygiene and Tropical Medicine has formulated a protocol (DEGREE (Disadvantaged Populations eGFR Epidemiology protocol) to studying CKDu which involves a cross-sectional study to identify the high-risk locations followed by a prospective cohort design to determine risk factors for declining kidney functions. Adopting the DEGREE protocol, Sri Lanka completed the cross-sectional survey in 2017 and initiated the cohort in 2018 with annual follow-ups till 2022. |
| Objectives | Objective of this proposal is to conduct the fourth annual follow-up to determine risk factors for declining kidney functions in the selected high-risk locations in Sri Lanka. |
| Study Methods | The study settings are located in the Anuradhapura district. A sample size of 750 healthy residents of 20-60 years were recruited with 729, 709 and 723 attending the annual follow-ups in 2018, 2019, 2021, respectively. At each survey, biological samples for kidney functions are obtained while samples for potential environmental risk factors of heavy metals, agrochemical residues are bio-banked. An interviewer-administered questionnaire collects information on environmental and behavioural risk factors and body composition measurements are performed. In determining risk factors estimates of eGFR trajectories will be examined using growth mixture modeling (GMM) and proposed exposures will be assessed using probability-weighted multinomial logistic regression examining exposures individually. Ethics clearance has been obtained and renewed from the Ethics Review Committee of the Faculty of Medicine, University of Colombo. |
| Expected outcomes and use of results | The information gathered from this study will help to identify potential risk factors for a condition which has burdened the communities for over two decades with room to implement preventive measures in the communities. Thus, the community will benefit. |
| Keywords | declining kidney functions; Chronic kidney disease of unknown aetiology; CKDu |
Research Details
| Student research | No |
| Start Date | 01-Sep-2022 |
| End Date | 30-Nov-2022 |
| Key Implementing Institution | Non-Communicable Diseases Unit, Ministry of Health |
| Multi-country research | No |
| Nationwide research | No |
| Sri Lanka | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Non-communicable Disease, |
| Involves human subjects | Yes |
| Population-Based Survey | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | Final decision available |