Exploring the Geographical Distribution of Groundwater Sources  and their Associations to Chronic Kidney Diseases: A Review

Ali Suleiman  Arzek; Bilal Muayad Abdulrahem  Alalosy; Mohammed R.  Al-Shaheen; Ayoob  Alqurqash

doi:10.17605/cajmns.v6i3.2720

Ali Suleiman Arzek Anbar Education Directorate, Ministry of Education, Iraq
Bilal Muayad Abdulrahem Alalosy Upper Euphrates Basin Developing Centre, University of Anbar, Iraq
Mohammed R. Al-Shaheen Laboratory Department, Ramadi Teaching Hospital, Anbar Health Directorate, Ministry of Health, Iraq
Ayoob Alqurqash Upper Euphrates Basin Developing Centre, University of Anbar, Iraq

DOI: https://doi.org/10.17605/cajmns.v6i3.2720

Keywords: Chronic Kidney Disease, Renal Disease, Groundwater, Water End-stage

Abstract

This review explores the geographical distribution of groundwater sources and their potential link to chronic kidney diseases (CKD), with a focus on relevancy to Iraq. Groundwater is a crucial water source for many regions, including parts of Iraq, and its availability and quality vary significantly across geographical locations due to geological, hydrological and anthropogenic factors. The review examines studies and data from various locations including Sri Lanka, India, Bangladesh, Mauritania, Saudi Arabia and Iraq to identify patterns and associations between groundwater quality and CKD prevalence. These regions provide useful case studies due to widespread groundwater usage, available research, and diverse environmental settings. The findings highlight how groundwater mineral composition can impact CKD rates in different areas. In Iraq, chronic kidney disease has spread widely in recent years as some communities have increasingly relied on groundwater extraction for drinking and irrigation, due to declining flows in the Tigris and Euphrates rivers. The review investigates factors influencing groundwater quality and considers their potential influence on chronic kidney disease in Iraq and other regions. While an association between groundwater and CKD is evident, additional research is still needed to fully characterize this relationship and its public health implications when accounting for confounding variables and clarifying mechanisms. The review provides valuable insights for studying the spatial distribution of CKD in Iraq and surrounding areas.

References

S. Indika, Y. Wei, T. Cooray, T. Ritigala, K. B. S. N. Jinadasa, S. K. Weragoda, and R. Weerasooriya, "Groundwater-based drinking water supply in Sri Lanka: Status and perspectives," Water, vol. 14, no. 9, p. 1428, 2022.

S. Imbulana and K. Oguma, "Groundwater as a potential cause of Chronic Kidney Disease of unknown etiology (CKDu) in Sri Lanka: a review," Journal of Water and Health, vol. 19, no. 3, pp. 393–410, 2021.

R. R. Weil, R. A. Weismiller, and R. S. Turner, "Nitrate contamination of groundwater under irrigated coastal plain soils," Am. Soc. Agron., Crop Sci. Soc. Am., Soil Sci. Soc. Am., vol. 19, no. 3, pp. 441–448, 1990.

A. E. Marín Celestino, D. A. Martínez Cruz, E. M. Otazo Sánchez, F. Gavi Reyes, and D. Vásquez Soto, "Groundwater quality assessment: An improved approach to K-means clustering, principal component analysis and spatial analysis: A case study," Water, vol. 10, no. 4, p. 437, 2018.

M. J. Nematollahi, P. Ebrahimi, and M. Ebrahimi, "Evaluating hydrogeochemical processes regulating groundwater quality in an unconfined aquifer," Environ. Process., vol. 3, pp. 1021–1043, 2016.

C. B. Dissanayake, "Water quality in the dry zone of Sri Lanka—some interesting health aspects," 2005.

J. Lunyera, D. Mohottige, M. Von Isenburg, M. Jeuland, U. D. Patel, and J. W. Stanifer, "CKD of uncertain etiology: a systematic review," Clin. J. Am. Soc. Nephrol., vol. 11, no. 3, pp. 379–389, 2016.

W. V. D. Priyadarshani, A. F. D. de Namor, and S. R. P. Silva, "Rising of a global silent killer: critical analysis of chronic kidney disease of uncertain aetiology (CKDu) worldwide and mitigation steps," Environ. Geochem. Health, vol. 45, no. 6, pp. 2647–2662, 2023.

S. Wickramarathna, S. Balasooriya, S. Diyabalanage, and R. Chandrajith, "Tracing environmental aetiological factors of chronic kidney diseases in the dry zone of Sri Lanka—A hydrogeochemical and isotope approach," J. Trace Elem. Med. Biol., vol. 44, pp. 298–306, 2017.

S. Imbulana, K. Oguma, and S. Takizawa, "Seasonal variations in groundwater quality and hydrogeochemistry in the endemic areas of Chronic Kidney Disease of Unknown Etiology (CKDu) in Sri Lanka," Water, vol. 13, no. 23, p. 3356, 2021.

P. K. Jha and P. Tripathi, "Arsenic and fluoride contamination in groundwater: a review of global scenarios with special reference to India," Groundwater for Sustainable Development, vol. 13, p. 100576, 2021.

G. S. Bhunia, P. K. Shit, P. P. Adhikary, and D. Sengupta, "Groundwater research and societal development: integration with remote sensing and geographical information system," in Groundwater and Society: Applications of Geospatial Technology, 2021, pp. 29–52.

M. A. Hashim, S. Mukhopadhyay, J. N. Sahu, and B. Sengupta, "Remediation technologies for heavy metal contaminated groundwater," J. Environ. Manag., vol. 92, no. 10, pp. 2355–2388, 2011.

V. Elumalai, K. Brindha, and E. Lakshmanan, "Human exposure risk assessment due to heavy metals in groundwater by pollution index and multivariate statistical methods: a case study from South Africa," Water, vol. 9, no. 4, p. 234, 2017.

X. Zeng, W. He, H. Guo, C. He, Q. Shi, Q. Shi, and M. Vithanage, "Molecular linkage of dissolved organic matter in groundwater with prevalence of chronic kidney disease with unknown etiology," Exposure Health, vol. 15, no. 3, pp. 489–503, 2023.

K. Y. Chang, I. W. Wu, B. R. Huang, J. G. Juang, J. C. Wu, S. W. Chang, and C. C. Chang, "Associations between water quality measures and chronic kidney disease prevalence in Taiwan," Int. J. Environ. Res. Public Health, vol. 15, no. 12, p. 2726, 2018.

M. Vithanage, T. Mikunthan, S. Pathmarajah, S. Arasalingam, and H. Manthrithilake, "Assessment of nitrate-N contamination in the Chunnakam aquifer system, Jaffna Peninsula, Sri Lanka," SpringerPlus, vol. 3, p. 1–8, 2014.

R. Chandrajith, S. Diyabalanage, and C. B. Dissanayake, "Geogenic fluoride and arsenic in groundwater of Sri Lanka and its implications to community health," Groundwater for Sustainable Development, vol. 10, p. 100359, 2020.

K. E. Levine, J. H. Redmon, M. F. Elledge, K. P. Wanigasuriya, K. Smith, B. Munoz, et al., "Quest to identify geochemical risk factors associated with chronic kidney disease of unknown etiology (CKDu) in an endemic region of Sri Lanka—a multimedia laboratory analysis of biological, food, and environmental samples," Environ. Monit. Assess., vol. 188, pp. 1–16, 2016.

S. Xu, S. L. Li, F. Yue, C. Udeshani, and R. Chandrajith, "Natural and anthropogenic controls of groundwater quality in Sri Lanka: Implications for chronic kidney disease of unknown etiology (CKDU)," Water, vol. 13, no. 19, p. 2724, 2021.

D. T. Jayawardana, H. M. T. G. A. Pitawala, and H. Ishiga, "Groundwater quality in different climatic zones of Sri Lanka: focus on the occurrence of fluoride," Int. J. Environ. Sci. Dev., vol. 1, no. 3, pp. 244–250, 2010.

S. A. Wimalawansa and S. J. Wimalawansa, "Environmentally induced, occupational diseases with emphasis on chronic kidney disease of multifactorial origin affecting tropical countries," Ann. Occup. Environ. Med., vol. 28, p. 1–13, 2016.

K. Lal, M. Sehgal, V. Gupta, A. Sharma, O. John, B. Gummidi, et al., "Assessment of groundwater quality of CKDu affected Uddanam region in Srikakulam district and across Andhra Pradesh, India," Groundwater for Sustainable Development, vol. 11, p. 100432, 2020.

N. O. Kitterød, J. Kværner, P. Aagaard, J. Arustienė, J. Bikše, A. Dagestad, et al., "Hydrogeology and groundwater quality in the Nordic and Baltic countries," Hydrol. Res., vol. 53, no. 7, pp. 958–982, 2022.

S. Indika, D. Hu, Y. Wei, I. Yapabandara, T. Cooray, M. Makehelwala, et al., "Spatiotemporal variation of groundwater quality in North Central Province, Sri Lanka," ACS ES&T Water, vol. 3, no. 6, pp. 1687–1698, 2023.

F. Alshehri and K. Abdelrahman, "Groundwater potentiality of Wadi Fatimah, Western Saudi Arabia: Geophysical and remote sensing integrated approach," Water, vol. 15, no. 10, p. 1828, 2023.

M. Asmamaw and E. Debie, "Characterizing groundwater quality for a safe supply of water using WQI and GIS in Bahir Dar city, northwest Ethiopia," Water Pract. Technol., vol. 18, no. 4, pp. 859–883, 2023.

A. I. A. S. S. Andrade and T. Y. Stigter, "Multi-method assessment of nitrate and pesticide contamination in shallow alluvial groundwater as a function of hydrogeological setting and land use," Agric. Water Manag., vol. 96, no. 12, pp. 1751–1765, 2009.

I. D. U. H. Piyathilake, W. A. C. Udeshani, H. A. C. S. Hapuarachchi, L. V. Ranaweera, E. P. N. Udayakumara, S. K. Gunatilake, and C. B. Dissanayake, "Geochemistry of groundwater in the Uva province, Sri Lanka—implications for chronic kidney disease of uncertain origin," Front. Water, vol. 3, p. 771501, 2021.

R. Mondal, P. C. Banik, M. Faruque, S. R. Mashreky, and L. Ali, "Association of exposure to salinity in groundwater with chronic kidney disease among diabetic population in Bangladesh," PLoS One, vol. 18, no. 4, p. e0284126, 2023.

M. Makehelwala, Y. Wei, S. K. Weragoda, R. Weerasooriya, and L. Zheng, "Characterization of dissolved organic carbon in shallow groundwater of chronic kidney disease affected regions in Sri Lanka," Sci. Total Environ., vol. 660, pp. 865–875, 2019.

J. M. Jayasekara, D. M. Dissanayake, S. B. Adhikari, and P. Bandara, "Geographical distribution of chronic kidney disease of unknown origin in North Central Region of Sri Lanka," Ceylon Med. J., vol. 58, no. 1, pp. 6–10, 2013.

K. Kafle, S. Balasubramanya, and T. Horbulyk, "Prevalence of chronic kidney disease in Sri Lanka: a profile of affected districts reliant on groundwater," Sci. Total Environ., vol. 694, p. 133767, 2019.

D. L. Jayasekera, J. J. Kaluarachchi, and K. G. Villholth, "Groundwater stress and vulnerability in rural coastal aquifers under competing demands: a case study from Sri Lanka," Environ. Monit. Assess., vol. 176, pp. 13–30, 2011.

R. Rubasinghe, S. K. Gunatilake, and R. Chandrajith, "Geochemical characteristics of groundwater in different climatic zones of Sri Lanka," Environ. Earth Sci., vol. 74, pp. 3067–3076, 2015.

S. Premarathne, R. Chandrajith, N. Nanayakkara, C. D. Gamage, N. Ratnatunga, S. Wijetunge, et al., "Could consumption of trace element–contaminated rice Be a risk factor for acute interstitial nephritis with uncertain etiology in the dry zone of Sri Lanka?," Biol. Trace Element Res., pp. 1–9, 2022.

C. B. Dissanayake, "The fluoride problem in the ground water of Sri Lanka—environmental management and health," Int. J. Environ. Stud., vol. 38, no. 2–3, pp. 137–155, 1991.

T. Cooray, Y. Wei, H. Zhong, L. Zheng, S. K. Weragoda, and R. Weerasooriya, "Assessment of groundwater quality in CKDu affected areas of Sri Lanka: implications for drinking water treatment," Int. J. Environ. Res. Public Health, vol. 16, no. 10, p. 1698, 2019.

R. Chandrajith, S. Nanayakkara, K. Itai, T. N. C. Aturaliya, C. B. Dissanayake, T. Abeysekera, et al., "Chronic kidney diseases of uncertain etiology (CKDue) in Sri Lanka: geographic distribution and environmental implications," Environ. Geochem. Health, vol. 33, pp. 267–278, 2011.

S. J. Wimalawansa, "Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations," Environ. Health Prev. Med., vol. 19, no. 6, pp. 375–394, 2014.

S. A. Wimalawansa and S. J. Wimalawansa, "Impact of changing agricultural practices on human health: Chronic kidney disease of multi-factorial origin in Sri Lanka," Wudpecker J. Agric. Res., vol. 3, no. 5, pp. 110–124, 2014.