Chronic kidney disease (CKD) of unknown etiology (CKDu) is a serious health issue in Sri Lanka. One-to-one age and sex-matched two sample comparative study was carried out in the Medawachchiya divisional secretariat area of the North Central Province (NCP) of Sri Lanka, by randomly selecting 100 CKDu patients and 100 age and sex-matched subjects from non-CKDu affected families from the same area. An interviewer-administered questionnaire was used for the collection of data pertaining to occupation, medical history and lifestyle. Data were analyzed using a conditional linear logistic model. Working for >6 h in the field per day, exposure to sun, drinking water only from well, consumption of <3 L of water per day, and having a history of malaria were found to be having significant (P < 0.05) likelihood toward the development of CKDu. Treatment of water prior to consumption had a significant protective effect against CKDu. Dehydration, history of malaria and drinking untreated well water from are likely contribute to the development of CKD of unknown etiology among the inhabitants of NCP, Sri Lanka.

BackgroundExact mechanism of causation of chronic kidney disease of unknown etiology (CKDu) in Sri Lanka is not described to date, despite the identification of possible multiple risk factors. Questions have been raised as to why only some are affected while others remain intact, though they are inhabitants of the same locality.MethodsComparative studies were carried out, assessing urinary β2 microglobulin (β2m) and the dietary patterns of CKDu patients and age sex matched non-CKDu subjects. Urinary β2m levels of spot urine samples were analyzed using the Enzyme-linked Immunosorbent assay (ELISA) and dietary patterns were studied using twenty four hour dietary recalls and frequency consumption of foods of animal origin performed on three occasions at six months intervals within a period of one and half years.ResultsThe mean urinary β2m level of CKDu patients from Medawachchiya was significantly (p < 0.05) higher when compared with that of the non-CKDu subjects. The mean urinary β2m level of the non-CKDu subjects was within the reference limits for spot urine samples (0 – 0.3 μg/mL). White raw rice was the staple diet of both CKDu patients and non-CKDu subjects and the level of consumption was almost the same. The consumption of fresh water fish products of CKDu patients under high (14, 14%), moderate (36, 36%), low (26, 26%) and less (20, 20%) categories did not show significant variations (p > 0.05) compared to non-CKDu subjects.ConclusionsStaple food in diet and the consumption pattern of CKDu patients from Medawachchiya were similar to that of non-CKDu subjects from the same area despite their urinary β2m concentration being significantly higher.

The habitual drinking water is likely to be a contributory factor towards the progression of the disease.

Background Fat in certain body compartments has a significant contribution to dyslipidemia. Objective The objective was to determine the fat distribution in various body compartments among management assistants (clerks: sedentary occupational group), from the Anuradhapura Municipal Council area, Sri Lanka and to estimate their lipid profiles for any correlation with fat distribution. Methods In this descriptive cross-sectional study [n=78; males=15(mean age=38(11) years); females=63 (mean age=39(9) years)], weight, height, waist and hip circumferences were measured using standard WHO methods. Body fat was measured using 8 electrode bio impedance analyzer system (HBF375 Karada Scan, Japan). Lipid profile was estimated using colorimetric assay kit methods. Results According to the BMI, 57% of females were obese and 13% were overweight, and 67% of males were obese and 20% were overweight. Abdominal obesity [WC>90cm males; >80cm females] was present in 73% of males and 81% of females. Based on total BF% (males>25%; females>35%-obese), 73% males and 65% females were obese. Twenty nine percent of females and 73% of males had a high visceral fat percentage (>10%). This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY) Among the females, 68%, 17%, 92% and among males, 73%, 27%, 80% had hypercholesterolaemia, hypertriglyceridemia and high LDL levels, respectively. Low HDL levels were observed in 47% of males and 68% of females. Conicity index (CI) and body adiposity index (BAI) were at high risk level in 93% of males and 75% of females and 27% of males and 56% of females, respectively. Conclusion The prevalence of overweight and obesity was high among the individuals of the study group and a majority were unaware that they were dyslipidemic.