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Exposure to acetylcholinesterase-inhibiting pesticides and chronic renal failure.

Recent reports show an increase in the incidence of end-stage renal disease of unknown aetiology from the North-Central Province of Sri Lanka [1]. As the majority of the patients are from rural farming communities, pesticide exposure is suspected as a cause, although it is not a proven aetiological factor for chronic renal failure (CRF). Acetylcholinesterase (AChE)-inhibiting insecticides are the most widely used pesticides in Sri Lanka. Although nephrotoxicity is not recognised as a clinical feature of anticholinesterase poisoning, there are reports of acute renal failure provoked by acute tubular necrosis [2] and rabdomyolysis [3] following high dose OP exposure. This preliminary study was conducted to determine if there is an association between CRF of unknown aetiology and organophosphate (OP) exposure.