Explore the vast range of titles available.

A chronic Kidney Disease of unknown etiology (CKDu) has emerged with disproportionately high prevalence across dry lowland agricultural communities globally. Here we present the results of a prospective cohort of 293 patients with CKDu in the endemic region of Wilgamuwa, Sri Lanka, in whom we measured baseline kidney function and undertook quarterly follow up over 2 years. Well water was the primary historic drinking water source in the region, although a majority (68%) of participants reported switching to reverse osmosis water during study follow ups. Participants who reported ever drinking from well water had estimated glomerular filtration rates −6.7 (SD: 2.8) ml/min/1.73 m 2 lower than participants who did not drink from well water historically ( p  = 0.0184) during the study period. Geospatial analysis identifies a cluster within the region where CKDu progression is significantly higher than the surrounding area. Samples of household wells ( n  = 262) indicated 68% had detectable agrochemical compounds with concentration above global water quality standards. It is expected that the detected contaminants compounds are indicators of poor water quality and that there is likely additional agrochemical exposure including commercial additives that may contribute to CKDu onset and/or progression. Thus, our study finds that well water exposure during a person’s lifetime in this region is associated with kidney function decline and identifies and quantifies putative nephrotoxic agrochemicals above safe drinking water concentrations in these wells.

Fibromuscular dysplasia (FMD) is a rare systemic vascular disease that has been found to present as a renal infarction (RI) in only a handful of cases.  We present a case of a 53-year-old Vietnamese patient presenting for sharp, severe left-sided abdominal pain of two-day duration associated with a migraine headache. On presentation, she was afebrile, and her vital signs were stable. Laboratory investigations were significant for mildly elevated leukocytosis but were otherwise normal. CT abdomen and pelvis with contrast revealed a left-sided renal infarct. The patient was then admitted to the hospital and started on therapeutic anticoagulation. A transthoracic echocardiogram was obtained and revealed no vegetation. CT angiography of the abdomen was pursued and was significant for mild beading within the mid-right and left renal arteries, consistent with fibromuscular dysplasia. Our patient was diagnosed with renal infarction in the setting of fibromuscular dysplasia, a combination that has been reported only a few times. Interestingly, our patient also had mild FMD based on imaging, making it even more of an unusual cause of renal infarction. This case highlights the connection between these two diseases and the need for more studies to characterize the association between them.

Drought and low amounts of mineral nutrients in the soil are the two leading global constraints in arid and semiarid regions. Their detrimental effects on soils and crops can be alleviated by applying controlled release and biodegradable fertilizers to better and sustain the crops. On a global scale, spinach (Spinacia oleracea L.) is an essential leafy green vegetable that is biologically considered a reliable source of essential nutrients and minerals for human health. A comprehensive approach is needed to manage water stress to mitigate the impacts of stress-caused damage and to examine this for better and increased plant production. An experiment was conducted using potassium-nitrate-containing chitosan/montmorillonite microparticles (150 mg) under mild and severe drought stress (MDS: 50% and SDS: 35% FC, respectively). The treatments include control (no KNO3 and 70% FC as normal irrigation (NI)), KNO3 + NI, 50% FC as mild drought stress (MDS), KNO3 + MDS, 35% FC as severe drought stress (SDS) and KNO3 + SDS. Results revealed that drought stress decreased all studied physiological parameters and increased oxidative stress indicators in spinach. Applying KN significantly increased root (122%) and shoot length (4%), shoot fresh weight (32%) and shoot dry weight (71%), chlorophyll a (88%), carotenoids (39%), total soluble proteins (50%), soluble sugars (51%), potassium (80%), and phosphorous (32%) concentrations over No KN at severe drought. While stress indicators, like glycine betaine, malondialdehyde, hydrogen peroxide, electrolyte leakage, peroxidase, superoxide dismutase, and ascorbic acid levels, were increased in stress. Treatment KN was proved efficient and effective in improving spinach physiological status in both MDS and SDS.