Challenges in controlling chronic kidney diseases of unknown etiology in Sri Lanka

Abstract

Among infectious and non-infectious diseases, Chronic Kidney Disease of Unknown Etiology (CKDU) has attracted the attention of the public, researchers, medical officers and practitioners all over Sri Lanka. The aim of this study is to review the literature related to the status of CKDU with special emphasis on the challenges faced in the control of CKDU in Sri Lanka. This study is literature based and the published research articles were obtained through electronic databases. This disease is caused by several factors such as aflatoxins in grains, heavy metal contaminations such as arsenic toxicity in grains as well as water and cadmium in food sources. In addition, fluoride, aluminum and genetic factors are also considered as causative agents of CKDU. Though the causative factors are wide spread in Sri Lanka, some specific areas are more vulnerable to CKDU. We, therefore, thought it will be interesting to find out whether other factors have an overriding influence on the occurrence of CKDU. In the literature, over consumption of contaminated drinking water, unlimited usage of pesticides and fertilizers, traditional farming methods, limited research studies on social behavior related to CKDU, poor dissemination of information regarding research results and standard agricultural practices are identified as important challenges. This review concluded more efficient strategies such as pest management, use of genetically modified pests, changes in social behavior of farmers, improving the health system of Sri Lanka, using advanced technologies in farming and carrying out further research on assessing the overriding factors may help us face the challenges in controlling CKDU in Sri Lanka.