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Abstract: TH-PO1057

Chronic Interstitial Nephritis in Agricultural Communities (CINAC) Is Strongly Associated with Pesticides

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Jayasumana, Channa, Faculty of Medicine, Anuradhapura, Sri Lanka
  • Herath, Chulani Aravinda, Sri Jayawardenepura General Hospital, Colombo 5, Sri Lanka
  • De Broe, Marc E., University of Antwerp, Lokeren, Ghent, Belgium

Pesticides are hypothesized as a main etiological factor behind CINAC. Our aim was to see whether pesticides are associated with CINAC.


A case control study was carried out in a CINAC endemic region in Sri Lanka. Confirmed cases with CINAC (N=125) and controls (N=180) were recruited to the study. Socio-demographic and data related to usage of applying pesticides were studied. Participant’s urine samples were analyzed using ELISA to determine the levels glyphosate and paraquat.


In the epidemiological study, we found CINAC is strongly associated with overall pesticide application (OR 2.34, 95% CI; 0.97-5.57), use of glyphosate (OR 5.12, 95% CI; 2.33-11.26) and use of paraquat (OR 4.53, 95% CI; 1.23-10.03) adjusted for age, sex, education, family history of CINAC and exposure modifiers. In the analytical study it has been shown that creatinine adjusted values of urinary glyphosate in CINAC cases (12.7 µg/g creatinine) was significantly higher when compared to non-endemic controls (2.4µg/g creatinine). Further, we found paraquat residues are still present in urine samples (Mean 1.08, Min-0, Max-11.42 µg/g creatinine) obtained from people living in CINAC endemic regions despite parquet had been banned in 2010 in Sri Lanka.Similar association between CKD and pesticide usage is previously reported. In 2015 Lebov and colleagues have shown herbicides alachlor, atrazine, metolachlor, paraquat, and pendimethalin, and the insecticide permethrin are associated with end stage renal disease (ESRD) in USA among licensed pesticide applicators.


Epidemiological and toxicological findings suggest CINAC is a toxic nephropathy associated with paraquat and glyphosate.