Chronic Kidney Disease (CKD) in Sri Lanka - Current Research Evidence Justification: A Review

Abstract

In this article, the current scientific evidence of Chronic Kidney disease with unknown aetiology (CKDu), were critically reviewed and harnessed with other relevant literature with a view to justify the possible causative reason(s) for this chronic health problem. To this end, authors first reviewed the literature on socio-economic, environmental, meteorological, health and geo-environmental/chemical aspects in relation to the CKD of unknown aetiology in Sri Lanka and then studied the known aetiology of CKD (key medical facts) in detail highlighting a comprehensive list of causes. Based on the nature of economic development in the CKDu prevailing area, previous studies have suggested that the causative factor for CKDu is probably environmental and is related to the nature of anthropogenic activities. Therefore, authors investigated subject more into the chronic exposure to heavy metals associated with agricultural activities. Potential sources of heavy metals in the area are mentioned. The geochemical mobility and health effects of three selected elements namely arsenic (As), cadmium (Cd) and Lead (Pb) are studied in detail. The current scientific observations reported on CKD were evaluated with established chemical, geochemical, and health risk of As, Cd and Pb. According to the review, it can be justified that CKDu of the North Central Province (NCP) in Sri Lanka is a decease caused by the chronic exposure and cumulative effects of elevated levels of heavy metals associated with agricultural activities.