Molecular and cellular toxicity of fluoride in mystery, tubulointerstitial chronic kidney disease: a systematic review
Posted on October 24th, 2021

Sunil J. Wimalawansa

Abstract and Figures

Chronic kidney disease of multifactorial origin (CKDmfo), also known as CKD of uncertain origin (CKDu), is a tubulointerstitial disease. CKDmfo is an environmentally induced, preventable occupational disease that predominantly affects male farmers in tropical countries. Several causative factors have been proposed, including agrochemicals, heavy metals, medications, microbial/cyanobacterial toxins, illicit alcohol, microbes, dehydration, and fluoride. Properly conducted scientific data collections and analyses are lacking in relation to any of the postulated nephrotoxins, dehydration, genetics, or malnutrition as the genesis of CKDmfo. However, the disease can be experimentally induced in animals with chronic exposure to high-dose hard water containing fluoride or in combination with other nephrotoxins. Water fluoride levels in CKDmfo-affected regions vary, from less than 0.4 mg/L (0.4 ppm) in shallow wells to more than 1.5 mg/L in most tube wells, which are the two most-common sources of drinking water in the regions. Surface water from natural springs, reservoirs, and canals contains much lower concentrations of fluoride and hardness and those drinking such water have a significantly lower incidence of CKDmfo. Several animal studies reported that fluoride exacerbates the renal tubular oxidative stress that contributes to cell damage. This systematic review covers the mechanisms of fluoride-induced renal tubular cell damage, chemical interactions, and oxidative stress in persons with CKDmfo/CKDu. Although the disease is initiated by nanomineral formation in renal tubules together with chronic renal ischemia, fluoride can augment the nephrotoxicity. Renal tubular toxicity caused by CaPO4 nanocrystals and nanotubes is exacerbated by fluoride and other nephrotoxins, malnutrition, micronutrients and antioxidant deficiency, and conditions that increase oxidative stress. These data indicate key targets and modes of action that could be used to prevent this deadly disease. Although fluoride likely contributes, it is unlikely to be the sole cause of the tubulointerstitial renal damage of CKDmfo. Graphic abstract

3 Responses to “Molecular and cellular toxicity of fluoride in mystery, tubulointerstitial chronic kidney disease: a systematic review”

  1. Ratanapala Says:

    We wonder what kills the ‘living earth and her inhabitants’, the earth worms, leeches and other countless little creatures that enrich the our soils and waterways? We wonder what killed the litte fish – handa paluwas, kanayas, dandi, iriyas, mada kariyas, kaawayiyas,weli gowwas, hungas and maguras and then little kakuluwas? They are no more to be seen in our paddies and little water canals that border the paddies and in other waterways. When we were small all these little creatures added colour to our lives, sometimes as pets, at other times as simply nuisances and in death they enriched our soils.

    Can the disappearence of these creatures, most found spread all over the lands from highlands to lowlands, from wetlands to drylands be relegated to chlorides and other naturally found chemicals in the soil? Is it not true that all these can easily be laid at the introduction of chemical fertilizers in to the tea, rubber, coconut and paddy industries only a few decades ago.

    The dead soils must be given a chance to live again, enrich bio diversity and in the process support our agriculture, not to speak of the wonder and joy for our younger generations to get back to nature – the joys we were fortunate to be privy to!

    This is what the President tried to convey to the nation when he visited a carbonic fertilizer making facility recently.

  2. aloy Says:

    There are quite a few the current knowledge that we have cannot explain. The Covid affiar is one such thing the experts world over cannot figure out.
    But it is not so difficult for our folks now to identify the habitual liars.
    They say ‘gona herenakota karana dey dsnnawa’. You can fool some people for some time. But you cannot fool all the people all the time.

    One more thing: identify the K’gala syndrome.

  3. NeelaMahaYoda Says:

    You don’t have to repeat what Gota said recently. He is talking absolute rubbish. We all know that all our small rivers, creeks, and waterways are dried now and because of that little fish like handa, kanayas, Thithayas and Magura are no more. I would say It is not due to the presence of chemicals in the water. There are so many research papers published on chemical residue content in our waterways and none of the reports says the chemical content exceeds allowable limits for sustaining aquatic life. The main problem is the clearing of forests for timber and agriculture purposes results in losing vegetation that keeps the soil wet and keeps creeks and waterways flowing.

    Almost 60 years ago I was living in the village called Danovita, a valley surrounded by mountains covered with virgin forests bordering the upcountry demarcation. As a child, I used to enjoy the cold water coming through the waterways and creeks down the mountain slopes and we had enough water for us to swim in the river that flows through the foothills.

    Recently I visited that place and I could not believe how they got rid of the virgin forests in the mountains. No trace of creeks or waterways and the river looks like a culvert and without even sufficient water to wash my feet. Definitely, I was not looking for Thithayas, Kanayas, and Maguras there. It is not chemicals that destroy our environment, it was the politicians who clear the forest for expensive timber and hand the bare land to their supporters to cultivate.

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