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Lesson: Chapter 15 — The biosphere

15.4. Changing lifestyles and the problems they bring 4 of 6

Chronic kidney disease in Sri Lanka

The disease in which the kidneys fail within a short time, spreading in the agricultural areas of Sri Lanka, is called chronic kidney disease (CKD).

What is unusual about it

  • Chronic kidney failure usually strikes people with uncontrolled diabetes or high blood pressure, but this disease also affects people without such earlier illnesses.
  • Most patients work in agriculture; those who spray agrochemicals are at much higher risk.
  • The first patient was reported from the Padaviya farming settlement in 1994. At first farmers aged 50–60 were affected; now people of 25–30 are too, and more men than women.
  • Symptoms appear late, so people do not know for a long time; by the time they do, 40–60% of the kidneys may already have failed.
  • Most patients have been found to drink hard water.

Causes that have been identified: poisons released by blue-green algae entering the body; agrochemicals entering the body; heavy metals (such as Cd, Pb, As) entering the body; drinking water containing fluoride; dehydration; using medicines without supervision; drinking alcohol.

Ways to avoid chronic kidney disease

  • Avoid agrochemicals and food containing them.
  • Keep a healthy lifestyle that prevents and controls diabetes and high blood pressure.
  • Reduce urinary infections in childhood and adulthood.
  • An adult should drink 3.5–4.5 litres, or 5–6 bottles, of clean water a day.
  • Get prompt treatment for skin allergies (ringworm, scabies, leprosy).
  • Avoid misusing painkillers.
  • Avoid alcohol and cigarettes.

Why the cause is so hard to pin down

The disease is often called CKD of uncertain origin (CKDu) because no single cause explains it. The areas most affected share several things at once — hard, fluoride-rich groundwater, heavy use of agrochemicals, hot work that dehydrates farmers, and traces of heavy metals — and each may add to the harm the others do. What is clear is that the steps above reduce exposure to all of them together, and that safe drinking water, such as the reverse-osmosis plants installed in many villages, helps.

A farming-area kidney disease

CKD in Sri Lanka strikes farmers without diabetes or high blood pressure; agrochemicals, heavy metals, fluoride, hard water and dehydration are suspected.