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Mysterious kidney disease on the rise in South Asia

It was an enigma when it was discovered in the early 1990s. And despite the efforts of scientists in fields from hydrology to medicine, it largely remains so. Chronic kidney disease of unknown causes, or CKDu, has become a widespread threat to agricultural workers in South Asia, especially in Sri Lanka. CKDu is a growing health issue in more than a dozen countries in Asia, South America and the Middle East, scientists say. Sri Lanka is the most affected, with the highest number of CKDu patients. In 2014, Sri Lanka's Ministry of Health documented 16,479 CKDu cases. In 2015, the number was 20,828. The incidence of the disease has increased dramatically in the country's North Central Province (NCP). The NCP lies in Sri Lanka's dry zone, where freshwater is limited. To investigate the problem, the National Science Foundation awarded funding for a scientific workshop on CKDu. The workshop brought together hydrologists, engineers, occupational medicine specialists, social scientists and environmental health scientists for site visits to what may be "ground zero" in Sri Lanka's CKDu epidemic: NCP agricultural districts. The NCP covers some 16 percent of Sri Lanka's total area, making it the nation's largest province. But CKDu isn't limited to that region; it has now spread to adjacent provinces such as Uva, North Western, Northern, Central and Eastern. Because the disease occurs in specific geographic areas and the cause is likely related to multiple factors, an interdisciplinary approach is essential to discovering what's behind CKDu.

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