A pilot study of behavioral, environmental, and occupational risk factors for chronic kidney disease of unknown etiology in Sri Lanka

Abstract

23Mobile. +260 96 3088750 | +1 936-661-6885 24 ABSTRACT 25 Chronic kidney disease of unknown etiology (CKDu) was first recognized in Sri Lanka in the early 26 1990s, and since then it has reached epidemic levels in the North Central Province of the country.27 The prevalence of CKDu is reportedly highest among communities that engage in chena and paddy 28 farming, which is most often practiced in the dry zone including the North Central and East Central 29 Provinces of Sri Lanka. Previous studies have suggested varied hypotheses for the etiology of 30 CKDu; however, there is not yet a consensus on the primary risk factors, possibly due to disparate 31 study designs, sample populations, and methodologies. The goal of this pilot case-control study 32 was to evaluate the relationships between key demographic, cultural, and occupational variables 33 as risk factors for CKDu, with a primary interest in pesticide exposure both occupationally and 34 through its potential use as an ingredient in brewed kasippu alcohol. A total of 56 CKDu cases 35 and 54 control individuals were surveyed using a proctored, self-reported questionnaire. 36 Occupational pesticide exposure and alcohol consumption were not found to be significant risk 37 factors for CKDu. However, a statistically significant association with CKDu was observed with 38 chewing betel (OR: 6.11, 95% CI: 1.93, 19.35), age (OR: 1.07, 95% CI: 1.02, 1.13), owning a pet 39 dog (OR: 3.74, 95% CI: 1.38, 10.11), water treatment (OR: 3.68, 95% CI: 1.09, 12.43) and pests 40 in the house (OR: 5.81, 95% CI: 1.56, 21.60). The findings of this study suggest future research 41 should focus on practices associated with chewing betel, potential animal interactions including 42 pests in the home and pets, and risk factors associated with water.

Identification of Social and Occupational Risk Factors Associated with CKDu Patients in an Agricultural Community in Kebithigollewa, Sri Lanka

“…Men are affected more commonly than women and are in age range 20-50yrs with 40-50yrs of average presentation age. In Sri Lanka, mostly the rice paddy farmers living in rural areas are affected (Johnson, Wesseling and Newman, 2019;Pry et al, 2019).…”

“…According to studies, an approximate of 15-23% of the reported population in NCP is affected with CKDu and the numbers could be higher since majority of the CKDu cases are identi ed late in life. Hence, it's important to identify its risk factors, to lower and control the prevalence of new CKDu cases (Pry et al, 2019).…”

A study of lipid profile and glycemic status in patients with chronic kidney disease of unknown etiology in Sri Lanka

“…4 In Sri Lanka, CKDu was first discovered among young paddy cultivators in North Central province. 5 Since then high prevalence of CKDu were reported from several other areas in dry zone of the country. Even though several studies have been conducted worldwide to identify the etiology, the name CKDu remains appropriate because the cause of this disease remains unknown.…”

Chicken or the egg: Vitamin D deficiency in Chronic Kidney Disease of Uncertain Etiology in Sri Lanka

“…This new disease, the chronic kidney disease of uncertain etiology (CKDu), has different epidemiological characteristics over CKD. Notably, it predominantly affects the young and middle-aged males in rural discrete pockets of farming areas in tropical countries [3]. Hence, CKDu has become an emerging health problem in developing countries such as El Salvador, Egypt, India, Central America, Nicaragua and Sri Lanka [4].…”

“…Hence, CKDu has become an emerging health problem in developing countries such as El Salvador, Egypt, India, Central America, Nicaragua and Sri Lanka [4]. In Sri Lanka, CKDu was rst discovered among young paddy cultivators of North Central province in mid1990s [3]. A recent population based cross sectional study has reported point prevalence of CKDu in endemic areas of Sri Lanka ranging from 15.1-22.9% [5].…”