Chronic kidney disease (CKD) has emerged as an important non-communicable, global health epidemic. Importantly, CKD is becoming increasing prevalent in the developing world where diagnosis and treatment of renal disease is consuming a significant and growing portion of healthcare resources. In the 1990s, an apparently new form of CKD of unknown etiology (CKDu) began to emerge in Sri Lanka's North Central Province (NCP), located within the island nation's dry zone. It is slowly progressive, initially asymptomatic, and irreversible, directly impacting approximately 30K people to date, and growing. Sri Lankan CKDu is also characterized by renal tubular/interstitial damage, primarily burdening people of lower socioeconomic status working or living in agricultural areas. This presentation will review findings from CKDu field work in Sri Lanka (2013-14 and 2017) in targeted geographic areas. Biological (blood and urine) and environmental samples (drinking water, rice, soil and freshwater fish) from endemic areas in Sri Lanka were analyzed to determine the concentration of a suite of heavy metals and trace element nutrients, along with qualitative research of household health and farming practices. A broad panel, mineralomics approach was used to shed light on potential geochemical risk factors associated with CKDu.
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