Open Access Highly Accessed Correspondence

Additional perspectives on chronic kidney disease of unknown aetiology (CKDu) in Sri Lanka – lessons learned from the WHO CKDu population prevalence study

Jennifer Hoponick Redmon1*, Myles F Elledge2, Donna S Womack1, Rajitha Wickremashinghe4, Kamani P Wanigasuriya5, Roshini J Peiris-John6, Joseph Lunyera3, Kristin Smith1, James H Raymer2 and Keith E Levine2*

Author Affiliations

1 RTI International, Center for Health and Environmetnal Modeling, 3040 East Cornwallis Rd, Research Triangle Park, NC 27709-2194, USA

2 RTI International, Discovery Science Technology, 3040 East Cornwallis Rd, Research Triangle Park, NC 27709-2194, USA

3 Duke University, Global Health Institute, Durham, NC, USA

4 Department of Public Health, University of Kelaniya, Kelaniya, Sri Lanka

5 Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka

6 University of Auckland Epidemiology & Biostatistics Auckland, New Zealand

For all author emails, please log on.

BMC Nephrology 2014, 15:125  doi:10.1186/1471-2369-15-125

Published: 28 July 2014


The recent emergence of an apparently new form of chronic kidney disease of unknown aetiology (CKDu) has become a serious public health crisis in Sri Lanka. CKDu is slowly progressive, irreversible, and asymptomatic until late stages, and is not attributable to hypertension, diabetes, or other known aetiologies. In response to the scope and severity of the emerging CKDu health crisis, the Sri Lanka Ministry of Health and the World Health Organization initiated a collaborative research project from 2009 through 2012 to investigate CKDu prevalence and aetiology. The objective of this paper is to discuss the recently published findings of this investigation and present additional considerations and recommendations that may enhance subsequent investigations designed to identify and understand CKDu risk factors in Sri Lanka or other countries.

Chronic kidney disease; Chronic kidney disease of unknown aetiology; Environmental nephrotoxins; Sri Lanka; Heavy metals; Agrochemicals; Cadmium