Assessing the Effects of Water Quality and Intake on Chronic kidney Disease Progression in Western Libya

Adel Mahfoud; Assia Ramdan; Fatimah Alzahra Abdulnabi; Nour Gabasa; Ritaj Alriteemi

doi:10.54361/ajmas.258236

Authors

Adel Mahfoud Department of Medical Laboratory, Faculty of Medical Technology, University of Zawia, Zawia, Libya https://orcid.org/0009-0005-9692-8720
Assia Ramdan Department of Basic and General Science, Faculty of Dentistry, University of Zawia, Zawia, Libya https://orcid.org/0009-0001-3631-0428
Fatimah Alzahra Abdulnabi Department of Medical Nutrition, Faculty of Medical Technology, University of Zawia, Zawia, Liby. North Africa International Research Center for Serum, Vaccine, and Genetic Disease, Zawia, Libya https://orcid.org/0009-0008-5292-9205
Nour Gabasa Department of Medical Nutrition, Faculty of Medical Technology, University of Zawia, Zawia, Libya https://orcid.org/0009-0003-1465-6967
Ritaj Alriteemi Department of Medical Nutrition, Faculty of Medical Technology, University of Zawia, Zawia, Libya https://orcid.org/0009-0009-8645-636X

DOI:

https://doi.org/10.54361/ajmas.258236

Keywords:

Chronic Kidney Disease, Water Quality, Reverse Osmosis Water, Serum Electrolytes, e-GFR.

Abstract

Chronic kidney disease (CKD) has become a worldwide health problem driven by both identified and obscure causes. Besides the well-known causes of CKD, such as uncontrolled diabetes and hypertension, the quality of drinking water, particularly the hardness level, has been suggested by researchers as one of the causes of CKD. Monitoring and improving drinking water quality and quantity for CKD patients could delay the progression of kidney impairment. This cross-sectional study aims to evaluate the impact of water quality and quantity on the progression of CKD by analyzing biochemical parameters, serum electrolytes, and estimated glomerular filtration rate (e-GFR) in CKD patients. The study includes 106 CKD patients, comprising 50.9% males and 49.1% females. Among the study participants, over 40% were aged above 60 years. The majority (71.7%) consumed Reverse Osmosis (RO) water, while 28.3% drank well water. Regarding water intake, 52.8% of participants consumed one to two liters daily. Most participants (68%) had stage 4 CKD based on e-GFR. Urea and creatinine levels were elevated in both water source groups, though without statistical significance. However, significant differences were observed in serum electrolytes, with higher sodium (p=0.027), phosphate (p=0.025), and potassium (p=0.001) levels in the well water group. Additionally, e-GFR levels are significantly associated with water sources and water intake (chi-square = 0.041 and chi-square = 0.039, respectively). The study revealed that CKD patients consuming RO water and maintaining a moderate daily water intake (1–2 liters) exhibited better kidney function than those drinking well water or consuming significantly higher or lower amounts of water. These findings highlight the importance of both water quality and adequate intake in the clinical management of CKD patients.