Agricultural risk factors of chronic kidney disease of unknown aetiology in North Central Region of Sri Lanka

Abstract

Health professionals in Sri Lanka have noticed a high incidence of a new form of chronic kidney disease of unknown aetiology (CKO-U) in farmers of North Central Region (NCR). The aim of the study was to identify the risk factors related to farming in order to implement oreventive strategies. Potential agricultural risk factors and other information were collected through interviewer-administered questionnaires given to 315 CKO-U patients an I 321 healthy controls that were randomly selected. The relative risk of each factor was cornpared in terms of Odds ratios (ORs) and 95% confidence interval (CI) by applying the linear logistic model. In -olvernent In paddy farming activities (OR = 1.945. 95% CI: 1.256-3.010) usage of agro-chemicals (OR = 2.034, 95 % CI: 1297-3.190), poor preventive measures when using agro-chemicals (OR = 2845. 95% CI. 1788-4527), high operated paddy extent without exchange of labour (OR = 4734, 95% CI: 2.586-8.665) were identified as significant contributory risk factors for CKO-U (p < 0.005). Cultivating a large land extent without hiring labour was a significant risk factor for the disease (p < 005) Furthermore. cultivating smaller land extent without hired labour (OR = 1558,95% CI. 047-1.56) had higher risk than cultivating larger land extent with hired labour (OR = 140. 95% CI: 042- 142j In a adition to the agricultural activities. being a male. age> 60 years. smoking. alcoholism family history of CKO-U. history of malaria and snake bites (p < 0.05) were identified a, other contributory factors. There is a strong occupational risk factor in the pathogenesis of the disease where the male farmers of > 60 of age were at a high risk probably due to long term exposure to the aetiotogical agents (risk factors) Agricultural activities involving intense physical acivity were related to CKO-U Further studies are indicated to identify the effect of dehydraion and physical exertion on the renal functions of these individuals. Poor preventive measures in agrochemical usage related to the disease indicate the need to educate the farmers on safe agrochemical usage.