Chronic kidney disease of unknown etiology (CKDu) is spreading gradually in Sri Lanka. In the current research, 1,435 well water samples from all 25 districts of Sri Lanka, 91 rice samples, and 84 human urine samples from both CKDu-endemic and non-endemic areas in Sri Lanka were analyzed for arsenic, cadmium, lead, and chromium to detect whether toxic elements could be a cause of CKDu. The liver-type fatty acid binding protein (L-FABP) concentration and arsenic, cadmium, lead, and chromium concentrations of the urine samples were analyzed to determine the relation of L-FABP with arsenic, cadmium, lead, and chromium. High concentrations of arsenic, cadmium, lead, and chromium were not detected in the well water samples from CKDu-endemic areas. Arsenic, cadmium, and lead contents in the rice samples from both CKDu-endemic and non-endemic areas were well below the Codex standard. There were no relationships between the L-FABP concentration and concentrations of arsenic, cadmium, lead, and chromium in urine. In addition, arsenic, cadmium, lead, and chromium concentrations in human urine samples from CKDu-endemic areas were not significantly different from those from non-endemic areas. These findings indicated that arsenic, cadmium, lead, and chromium could not cause CKDu.

A total of 1,304 well water samples from Sri Lanka were analyzed to assess the potential risk of drinking water to human health. Fluoride concentration of more than 1.0 mg/L was found in 20% of the wells, especially in the dry zone where CKDu is prevalent. Fluoride is a suspected cause of CKDu in the region. Nitrate concentrations of more than 50 mg/L were recorded in 2.2% of the wells in areas with intense agricultural activity. Arsenic concentrations of more than 10 µg/L were found in 0.9% of the wells. Contaminated well water could pose a potential risk to human health.

The ingestion of fluoride-contaminated water causes serious health issues in people all over the world. In the current study, the adsorption of fluoride onto chicken bone char (CBC) was investigated as a defluoridation technique. Finer-sized CBC with a diameter of 106–212 µm was used to investigate the fluoride adsorption capacity onto CBC. Results revealed that finer-sized CBC yielded an unusually high fluoride adsorption capacity of 11.2 mg/g at the equilibrium fluoride concentration of 10 mg/L. The study shows that CBC can be utilized in the defluoridation of drinking water and that finer-sized CBC enhances ion exchange to perform a higher adsorption capacity.

The effectiveness of regenerated chicken bone char (CBC) in fluoride removal was investigated in the present study. Heat treatment was studied as the regeneration method. Results revealed that the CBC regenerated at 673 K yielded the highest fluoride adsorption capacity, hence, 673 K was the best regenerating temperature. The study continued up to five regeneration cycles at the best regenerating temperature; 673 K. The CBC accounted to 16.1 mg F/g CBC as the total adsorption capacity after five regeneration cycles. The recovery percentage of CBC reduced from 79% at the first regeneration to 4% after five regeneration cycles. The hydroxyapatite structure of CBC was not changed during the fluoride adsorption by five regeneration cycles. The ion exchange incorporated with the chemical precipitation occurred during the fluoride adsorption. The repeated regeneration of CBC is possible and it could be used as a low cost defluoridation technique to minimize the wastage of bone char.