Chronic kidney disease of unknown origin is associated with environmental urbanisation in Belfast, UK

Jennifer McKinley*, Ute Mueller, Peter Atkinson, Ulrich Ofterdinger, Siobhan Cox, Rory Doherty, Damian Fogarty, Vera Pawlowsky-Glahn, Juan José Egozcue

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Chronic kidney disease (CKD), a collective term for many causes of progressive renal failure, is increasing worldwide due to ageing, obesity and diabetes. However, these factors cannot explain the many environmental clusters of renal disease that are known to occur globally. This study uses data from the UK Renal Registry (UKRR) including CKD of uncertain aetiology (CKDu) to investigate environmental factors in Belfast, UK. Urbanisation has been reported to have an increasing impact on soils. Using an urban soil geochemistry database of elemental concentrations of potentially toxic elements (PTEs), we investigated the association of the Standardised Incidence Rates (SIRs) of both CKD and CKD of uncertain aetiology (CKDu) with environmental factors (PTEs), controlling for social deprivation. A compositional data analysis approach was used through balances (a special class of log contrasts) to identify elemental balances associated with CKDu. A statistically significant relationship was observed between CKD with the social deprivation measures of employment, income and education (significance levels of 0.001,0.01 and 0.001 respectively), which have been used as a proxy of socio-economic factors such as smoking. Using three alternative regression methods (linear, generalised linear and Tweedie models), the elemental balances of Cr/Ni and As/Mo were found to produce the largest correlation with CKDu. Geogenic and atmospheric pollution deposition, traffic and brake wear emissions have been cited as sources for these PTEs which have been linked to kidney damage. This research, thus, sheds light on the increasing global burden of CKD and, in particular, the environmental and anthropogenic factors that may be linked to CKDu, particularly environmental PTEs linked to urbanisation.
Original languageEnglish
Pages (from-to)2597
Number of pages18
JournalEnvironmental Geochemistry and Health
Issue number7
Early online date24 Jun 2020
Publication statusPublished - 13 Jul 2021
EventConference of Society of Environmental Geochemistry and Health: SEGH 2019 - Manchester Metropolitan University , Manchester, United Kingdom
Duration: 01 Jul 201905 Jul 2019
Conference number: 35


  • Compositional data analysis
  • Renal disease
  • Social deprivation measures
  • Soil geochemistry
  • Tweedie model
  • Uncertain aetiology

ASJC Scopus subject areas

  • Environmental Engineering
  • Environmental Chemistry
  • Water Science and Technology
  • General Environmental Science
  • Geochemistry and Petrology


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