Fig. 2
Illustrates the geological and biological (Geo–Bio) pathways of forming nano-tubes and nano-crystals in CKD–CTN. A conceptual diagram is illustrating ways for the formation of calcium phosphate (CaPO4) nano-crystal-based hydroxyapatite in renal tubules causing CKD–CTN: a interaction of rocks containing minerals rich in F−, Ca2+, Mg2+, PO43− with groundwater; long duration of water–rock interaction is exacerbate by seismic effects; c consumption of water with high concentrations of ions; d biochemical reactions and super-saturation, precipitating CaPO4 nano-crystals and nano-tubes in kidney tubules; e common factors enhancing the nano-mineral precipitation; f Low-grade persisting chronic inflammation and tissue fibrosis; and g Onset of chronic renal failure (adapted from Wimalawansa and Dissanayake, 2022; Frontiers of Water and human health) [10]