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Review
. 2019 Jul 31;16(15):2734.
doi: 10.3390/ijerph16152734.

Glyphosate's Synergistic Toxicity in Combination With Other Factors as a Cause of Chronic Kidney Disease of Unknown Origin

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Free PMC article
Review

Glyphosate's Synergistic Toxicity in Combination With Other Factors as a Cause of Chronic Kidney Disease of Unknown Origin

Sarath Gunatilake et al. Int J Environ Res Public Health. .
Free PMC article

Abstract

Chronic kidney disease of unknown etiology (CKDu) is a global epidemic. Sri Lanka has experienced a doubling of the disease every 4 or 5 years since it was first identified in the North Central province in the mid-1990s. The disease primarily affects people in agricultural regions who are missing the commonly known risk factors for CKD. Sri Lanka is not alone: health workers have reported prevalence of CKDu in Mexico, Nicaragua, El Salvador, and the state of Andhra Pradesh in India. A global search for the cause of CKDu has not identified a single factor, but rather many factors that may contribute to the etiology of the disease. Some of these factors include heat stroke leading to dehydration, toxic metals such as cadmium and arsenic, fluoride, low selenium, toxigenic cyanobacteria, nutritionally deficient diet and mycotoxins from mold exposure. Furthermore, exposure to agrichemicals, particularly glyphosate and paraquat, are likely compounding factors, and may be the primary factors. Here, we argue that glyphosate in particular is working synergistically with most of the other factors to increase toxic effects. We propose, further, that glyphosate causes insidious harm through its action as an amino acid analogue of glycine, and that this interferes with natural protective mechanisms against other exposures. Glyphosate's synergistic health effects in combination with exposure to other pollutants, in particular paraquat, and physical labor in the ubiquitous high temperatures of lowland tropical regions, could result in renal damage consistent with CKDu in Sri Lanka.

Keywords: CKDu; dehydration; glycine; glyphosate; kidneys; paraquat; pesticides.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Web of causation of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka.
Figure 2
Figure 2
Correlation between age-adjusted End Stage Renal Disease deaths and glyphosate applications and percentage of US corn and soy crops that are GE. (From Swanson et al., 2014) [61].
Figure 3
Figure 3
Correlation between age-adjusted renal failure deaths and glyphosate applications and percentage of US corn and soy crops that are GE. (From Swanson et al., 2014) [61].
Figure 4
Figure 4
Correlation between age-adjusted bladder/urinary tract cancer and glyphosate applications and percentage of US corn and soy crops that are GE. (From Swanson et al., 2014) [61].
Figure 5
Figure 5
Schematic of multiple ways that glyphosate could cause kidney disease, working in concert with multiple other toxic exposures. See text for details.

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References

    1. Jayasekara J.M., Dissanayake D.M., Adhikari S.B., Bandara P. Geographical distribution of chronic kidney disease of unknown origin in North Central Region of Sri Lanka. Ceylon Med. J. 2013;58:6–10. doi: 10.4038/cmj.v58i1.5356. - DOI - PubMed
    1. Jayasekara J.M., Dissanayake D.M., Gunaratne N., Ramiah S., Dissanayake D.M. Prevalence of G6PD deficiency in patients with chronic kidney disease of unknown origin in North Central region of Sri Lanka: Case control study. Int. J. Recent Sci. Res. 2013;4:455–458.
    1. Wimalawansa S.J. Agrochemicals and Chronic Kidney Disease of Multi-Factorial Origin: Environmentally Induced Occupational Exposure an Occupational Exposure Disease. Int. J. Nephrol. Kidney Fail. 2015;1 doi: 10.16966/2380-5498.111. - DOI
    1. Rajapakse S., Shivanthan M.C., Selvarajah M. Chronic kidney disease of unknown etiology in Sri Lanka. Int. J. Occup. Environ. Health. 2016;22:259–264. doi: 10.1080/10773525.2016.1203097. - DOI - PMC - PubMed
    1. Institute for Health Metrics and Evaluation. [(accessed on 2 December 2018)]; Available online: http://www.healthdata.org/el-salvador.

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