Abstract:
Chronic kidney disease of uncertain etiology (CKDu) and CKDu related deaths have risen
exponentially in Dehiattakandiya, Padiyathalawa and Mahaoya District Secretariat Divisions
(DSD) in Ampara District in the Eastern province. An increasing number of CKDu cases were
recently reported from Irakkamam DSD in Ampara District. Even though Irakkamam DSD is not
identified as a high-risk DSD for CKDu, there has been an increasing trend of CKDu recently as
per the preliminary surveys conducted. No studies have been reported from Irakkamam DSD
to find out the influencing factor associated with CKDu. Algal toxins play an important role
among the suspected contributing factors to CKDu. Therefore, the present study aimed to
analyse the concentration of algal toxins in drinking water to find out the association with the
occurrence of CKDu. Ten different geographical locations were selected to collect water
samples from various water sources including dug wells, tube wells, canals, reservoirs, and
water supply from the national water board in Irakkamam DSD in April 2022 during the dry
season to determine the concentrations of algal toxin. Enzyme-linked immunosorbent assay
(ELISA) method was used todetermine the algal toxins of Cylindrospermopsin and Microcystin.
The statistical analysis was performed using SPSS software. Algal toxin was only found in one
certain point of the reservoirarea out of the ten locations sampled. Further, the concentration
of Microcystin was detected as 1.576±0.06 µg/L in that location, which did not exceed the
standard level of 2.0 µg/L (SLS 614:2013). Moreover, Cylindrospermopsin was not detected in
drinking water samples analysed. Further, serum creatinine levels of the CKDu patients were
non-significantly (p >0.05) correlatedwith the concentration of algal toxins. So, algal toxin is not
a significant key determinant related to CKDu in Irakkamam DSD. Therefore, to identify a
potential etiological causing factor for theCKDu in Irakkamam DSD, other hypotheses should be
developed.
