CKD: Rural Sri Lanka’s Hidden Killer

What is CKD?

Chronic Kidney Disease (CKD) damages the kidneys, preventing them from performing their primary function of filtering the blood. Waste compounds and excess fluids are retained within the body, which can lead to other health conditions like strokes or heart disease. Left untreated, CKD can progress to complete kidney failure. It is asymptomatic in its early stages, making regular screening important for those at higher risk.

Why is CKD rural Sri Lanka's hidden killer?

Experts have identified a geographical correlation to CKD diagnosis in Sri Lanka, with prevalence of 15.1% and 22.9% recorded in the districts of Anuradhapura and Polonnaruwa respectively. This is mainly associated with rural farming communities, particularly those practising Chena cultivation, a traditional method of selecting and burning a small area of jungle for agriculture. Rural agricultural communities in the north-central dry zone account for 50% of the burden of tertiary nephrology treatment facilities in affected areas, with most patients men aged 40 to 69.

Studies point to drinking water sources located close to agricultural irrigation channels, with fertiliser and pesticide run-off seeping into wells and changing the water's chemical composition. Study subjects from endemic regions had higher concentrations of excreted heavy metals and glyphosate in their urine than the reference range.

With no known cure, CKD of unknown origin continues to cause irreversible kidney damage in affected communities, representing a significant national health burden for Sri Lanka.