Skip to main content

Mycotoxin Detection in Urine Samples from Patients with Chronic Kidney Disease of Uncertain Etiology in Sri Lanka


This was a screening study that aimed to determine the presence of nephrotoxic mycotoxins in urine samples from patients with chronic kidney disease of uncertain etiology in the North Central Province of Sri Lanka. The percentage detection of aflatoxins, ochratoxins and fumonisins in 31 patients were 61.29%, 93.5% and 19.4%, respectively. Geometric means of urinary aflatoxins and ochratoxins were 30.93 creatinine and 34.62 ng/g creatinine in chronic kidney disease of uncertain etiology stage 1–2 patients and 84.12 ng/g creatinine and 63.52 ng/g creatinine in unaffected relatives of patients. In chronic kidney disease of uncertain etiology stage 3–5 patients, geometric means of urinary aflatoxins and ochratoxins were 10.40 and 17.08 ng/g creatinine, respectively. Non-affected relatives of patients (n = 6) had comparable levels of these mycotoxins, but healthy Japanese individuals (n = 4) had lower levels than in Sri Lanka. The higher detection rate of urinary ochratoxins in Sri Lankans indicates that exposure is common in the region.

This is a preview of subscription content, access via your institution.


  1. Badria FA, Li S, Shier WT (1996) Fumonisins as potential causes of kidney disease. Toxin Rev 15:273–292

    Article  CAS  Google Scholar 

  2. Baudrimont I, Sostaric B, Yenot C, Betbeder AM, Dano-Djedje S, Sanni A, Steyn PS, Creppy EE (2001) Aspartame prevents the karyomegaly induced by ochratoxin A in rat kidney. Arch Toxicol 75:176–183

    Article  CAS  Google Scholar 

  3. Berndt WO, Hayes AW, Phillips RD (1980) Effects of mycotoxins on renal function: mycotoxic nephropathy. Kid Int 18:656–664

    Article  CAS  Google Scholar 

  4. Castegnaro M, Canadas D, Vrabcheva T, Petkova-Bocharova T, Chernozemsky IN, Pfohl-Leszkowicz A (2006) Balkan endemic nephropathy: Role of ochratoxins A through biomarkers. Mol Nutr Food Res 50:519–529

    Article  CAS  Google Scholar 

  5. Chandrajith R, Nanayakkara S, Itai K, Aturaliya TNC, Dissanayake CB, Abeysekera T, Harada K, Watanabe T, Koizumi A (2010) Chronic kidney diseases of uncertain etiology (CKDue) in Sri Lanka: geographic distribution and environmental implications. Environ Geochem Health. doi:10.1007/s10653-010-9339-1

  6. Domijan A-M, Peraica M, MArkov K, Fuchs R (2009) Urine Ochratoxin A and sphinganine/sphingosine ratio in residents of the endemic nephropathy area in Croatia. Arh Hig Rada Toksikol 60:387–393

    CAS  Google Scholar 

  7. Duarte S, Bento J, Pena A, Lino CM, Delerue-Matos C, Oliva-Teles T, Morais S, Correia M, Oliveira MB, Alves MR, Pereira JA (2010) Monitoring of ochratoxin a exposure of the Portuguese population through a nationwide urine survey—Winter 2007. Sci Total Environ 408:1195–1198

    Article  CAS  Google Scholar 

  8. Fazekas B, Tar A, KOVÁCS M (2005) Ochratoxin A content of urine samples of healthy humans in Hungary. Acta Vet Hung 53:35–44

    Article  CAS  Google Scholar 

  9. Glahn RP, Van Campen D, Dousa TP (1994) Aflatoxin B1 reduces Na(+)-P(i) co-transport in proximal renal epithelium: studies in opossum kidney (OK) cells. Toxicology 92:91–100

    Article  CAS  Google Scholar 

  10. Gong Y, Hounsa A, Egal S, Turner PC, Sutcliffe AE, Hall AJ, Cardwell K, Wild CP (2004) Postweaning exposure to aflatoxin results in impaired child growth: a longitudinal study in Benin, West Africa. Environ Health Perspect 112:1334–1338

    Article  CAS  Google Scholar 

  11. Grosman ME, Elias MM, Comin EJ, Garay EAR (1983) Alterations in renal function induced by aflatoxin B1 in the rat. Toxicol Appl Pharmacol 69:319–325

    Article  CAS  Google Scholar 

  12. Illeperuma OA, Dharmagunawardhane HA, Herarh KPRP (2009) Dissolution of aluminium from substandard utensils under high fluoride stress: a possible risk factors for chronic renal failures in the North-Central Province. J Natl Sci Found Sri Lanka 37:219–222

    Google Scholar 

  13. Koizumi A, Harada K, Inoue K, Hitomi T, Yang H-R, Moon C-S, Wang P, Hung N, Watanabe T, Shimbo S, Ikeda M (2009) Past, present, and future of environmental specimen banks. Environ Health Prev Med 14:307–318

    Article  Google Scholar 

  14. Malir F, Ostry V, Cernia M, Kacerovsky J, Roubal T, Skarkova J, Brndiar M, Fixa P (2004) Monitoring the important mycotoxin biomarkers (ochratoxin A, aflatoxin M1) in the Czech population. Cas Lek Cesk 143:691–696

    CAS  Google Scholar 

  15. Parsons D, Casado MR, Magan N, Dyer C, Weightman R (2007) Development of representative sampling plans for mycotoxins in foods using distribution modeling. Final report to the UK Food Standards Agency Project CO3055: Wolverhampton, ADAS UK Ltd

  16. Petzinger E, Weidenbach A (2002) Mycotoxins in the food chain: the role of ochratoxins. Livest Prod Sci 76:245–250

    Article  Google Scholar 

  17. Ringot D, Changoa A, Schneider YJ, Larondelle Y (2006) Toxicokinetics and toxicodynamics of ochratoxin A, an update. Chem Biol Interact 159:18–46

    Article  CAS  Google Scholar 

  18. Sauvant C, Holzinger H, Mildenberger S, Gekle M (2005) Exposure to nephrotoxic ochratoxin A enhances collagen secretion in human renal proximal tubular cells. Mol Nutr Food Res 49:31–37

    Article  CAS  Google Scholar 

  19. Silva LJ, Pena A, Lino CM, Fernandez MF, Manes J (2010) Fumonisin determination in urine by LC-MS-MS. Anal Bioanal Chem 396:809–816

    Article  CAS  Google Scholar 

  20. Wanigasuriya KP, Peiris H, Ileperuma N, Peiris-John RJ, Wickremasinghe R (2008) Could ochratoxin A in food commodities be the cause of chronic kidney disease in Sri Lanka? Trans R Soc Trop Med Hyg 102:726–728

    Article  Google Scholar 

  21. Zepnik H, Volkel W, Dekant W (2003) Toxicokinetics of the mycotoxin ochratoxin A in F 344 rats after oral administration. Toxicol Appl Pharmacol 192:36–44

    Article  CAS  Google Scholar 

Download references


This work was supported by special coordination funds for promoting science and technology sponsored by the Japan Science and Technology Agency. The funding agency had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors declare that they have no competing interests.

Author information



Corresponding author

Correspondence to Akio Koizumi.

Additional information

This study is conducted for the Chronic Kidney Disease of Uncertain Etiology Consortium.

Please refer the Appendix section for the full list of members.




Nation Collaborative institutes Members
Sri Lanka Faculty of Science, University of Peradeniya Rohana Chandrajith (CP)
Ayanthi Navarathna
Faculty of Medicine, University of Peradeniya N. Ratnatunga
Dhammika Dissanayake
Nimmi Aturaliya
K. Jayasekara
Ministry of Health and Nutrition [GH Kandy (Teaching), District Hospital Medawachchiya, District Hospital Girandurukotte] Tilak Abeysekara
A.W.M. Wazeel
Upul Karunaratne
KU Senaviratne
EDL Gunaratne
Institute of Fundamental Studies (IFS) C.B. Dissanayake
J.P. Padmasiri
  C.M. Madduma Bandara
Japan Department of Health and Environmental Sciences, Kyoto University Akio Koizumi (PI)
Kouji Harada
Toshiaki Hitomi
Shanika Nanayakkara
Lalantha Senevirathna
Kitano Hospital Eri Muso
Toshiyuki Komiya
Yoshiaki Yuba
Tohoku Bunkyo University Takao Watanabe
Daiichi Pharmaceutical University Koichi Haraguchi
Australia University of Qeensland Wendy Hoy
Glenda Gobe
Susan Mott

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Desalegn, B., Nanayakkara, S., Harada, K.H. et al. Mycotoxin Detection in Urine Samples from Patients with Chronic Kidney Disease of Uncertain Etiology in Sri Lanka. Bull Environ Contam Toxicol 87, 6 (2011).

Download citation


  • Chronic kidney disease of uncertain etiology
  • Sri Lanka
  • Urine sample
  • Aflatoxin
  • Ochratoxin
  • Fumonisin