Abstract
Since the mid-1990s, Sri Lanka’s North Central Province has faced an increasing occurrence of renal disease. As the aetiology has not been elucidated, the disease is known as Chronic Kidney Disease of unknown aetiology (CKDu). This paper covers Sri Lanka’s response to this debilitating and often fatal disease, and presents the chronology covering the national response. Further, the response has been covered from multiple angles, initially taking the broad national, political, private and international angle. Then a sectoral response analysis is presented, covering the medical, agriculture, food and nutrition, water, community and social sectors, as well as research and the media. Multiple action plans have been formulated and a consolidated action plan is currently being executed under the HE the President. A brief response analysis is presented at the end. Many a hypothesis regarding the causative agents/risk factors for CKDu has been suggested by researchers. Research compilation on presented hypotheses for causing CKDu in Sri Lanka is also presented.
Highlights
At the turn of the new millennium, the North Central Province (NCP) of Sri Lanka had started recording a higher-than-normal number of patients with kidney disease (Ramachandran, 1994; Kudalugoda Arachchi et al, 1999)
A case definition for Chronic Kidney Disease of unknown aetiology (CKDu) has been adopted by the Ministry of Health (Dassanayake & Herath, 2014), along with screening and clinical management guidelines for chronic kidney disease (CKD) and CKDu (MOH, 2014)
A critical look at the response indicates a lack of focused drive in identifying the cause of the disease, which is the most salient issue
Summary
At the turn of the new millennium, the North Central Province (NCP) of Sri Lanka had started recording a higher-than-normal number of patients with kidney disease (Ramachandran, 1994; Kudalugoda Arachchi et al, 1999). In the absence of an identifiable causative factor, as in the case of conventional renal failure, such as hypertension, diabetes, snake-bite or leptospirosis, the term ‘Chronic Kidney Disease of Unknown aetiology’ (CKDu) was adopted. A case definition for CKDu has been adopted by the Ministry of Health (Dassanayake & Herath, 2014), along with screening and clinical management guidelines for chronic kidney disease (CKD) and CKDu (MOH, 2014). National Kidney Foundation of Sri Lanka (NGO) launched a programme to establish a Renal Care and Renal Research Centre at Anuradhapura General Hospital as a publicprivate venture. MOH and WHO Joint Seminar on Unusual Occurrences of Chronic Kidney Disease in Sri Lanka, Blood Bank Auditorium, Colombo
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