In the rural heart of Sri Lanka, a mysterious and devastating health crisis is quietly unraveling lives. Chronic Kidney Disease of Unknown Etiology (CKDu) is targeting young men, particularly farmers and laborers, who have no history of diabetes or high blood pressure. This silent epidemic, most prevalent in areas like Anuradhapura and Polonnaruwa, has left thousands grappling with kidney failure, financial ruin, and uncertain futures. As of 2025, the crisis continues to grow, affecting entire communities and straining Sri Lanka’s healthcare system. This article explores the human toll, possible causes, and ongoing efforts to combat this unexplained wave of kidney damage in Sri Lanka.
A Growing Crisis Among Young Men
CKDu is unlike typical kidney disease. It strikes young and middle-aged men, often in their 20s to 50s, who are otherwise healthy. In Sri Lanka’s North Central Province, where rice fields stretch under relentless sun, up to one in five people in some villages show signs of kidney damage. The disease creeps in silently, with symptoms like fatigue, swelling, or back pain appearing only in late stages. By then, many require dialysis or transplants, treatments that are costly and scarce in rural areas. Estimates suggest over 20,000 Sri Lankans are now in end-stage kidney failure, with CKDu a major driver. The crisis hits hardest among men working outdoors, leaving families to bear the emotional and economic fallout.
What makes CKDu so alarming is its mystery. Unlike chronic kidney disease caused by known factors like diabetes, CKDu has no clear trigger. It’s concentrated in farming communities, where men toil in extreme heat, often without enough water or shade. Women and children are less affected, though cases are rising. The disease’s grip on Sri Lanka’s agricultural heartland has turned vibrant workers into patients, reshaping lives in villages where farming is both livelihood and identity.
Real Stories, Real Pain
The human cost of CKDu is heartbreakingly clear in the stories of those affected. In Ambagaswewa, a small village in Polonnaruwa, 63-year-old farmer Gamini Sunil Thennakoon has battled kidney issues for seven years. He still works his rice fields, wincing through pain, and travels 30 kilometers for medical check-ups. The costs pile up, draining his savings. His neighbor, 60-year-old U Subasinha, faces an even tougher reality. For eight years, he’s needed dialysis four times a week, a grueling routine that leaves his family struggling to afford basic needs. His wife, too, suffers from chronic pain, doubling their burden.
In coastal Batticaloa, 58-year-old fisherman Christy Navil works long hours at sea, where access to clean water is scarce. Dehydration has worsened his kidney condition, a common thread among his peers. In Pasikuda, 62-year-old Nadaraja Pereatambi underwent emergency kidney surgery two years ago, borrowing heavily to cover medical bills. He speaks of friends facing similar fates, blaming the salty, impure water they drink. In Negombo, 48-year-old Sirani Silva waits for a transplant, her kidneys functioning at just 10%. Her husband skips work to drive her to dialysis, pushing their family to the financial brink. These stories, repeated across Sri Lanka, paint a picture of a crisis robbing communities of health and hope.
Searching for the Cause
Why is CKDu spreading so rapidly? Scientists point to a mix of environmental and lifestyle factors unique to Sri Lanka’s rural dry zones. One leading theory blames contaminated groundwater, often drawn from shallow wells used for drinking and irrigation. Traces of pesticides, fertilizers, and heavy metals like arsenic or cadmium may accumulate in the body, slowly damaging kidneys. Another factor is the region’s hard water, high in salts and minerals, which strains kidneys over time. Farmers’ reliance on agrochemicals, including banned substances in some cases, adds to the risk.
The tropical climate plays a cruel role too. Young men working long hours in 35°C heat often can’t drink enough water to stay hydrated. This chronic dehydration, worsened by climate-driven droughts, stresses kidneys to the breaking point. Some researchers also explore links to past malaria infections or air pollution from burning crop residue. While no single cause explains CKDu, the combination of toxic water, extreme heat, and occupational hazards creates a perfect storm for Sri Lanka’s farmers and laborers.
A Nation’s Response in 2025
Sri Lanka has been fighting CKDu for decades, but the battle is far from won. In 2025, the government and international partners are stepping up efforts. Clean water programs have rolled out in hard-hit areas like the North Central Province, with some villages seeing fewer new cases as a result. Health campaigns now urge workers to stay hydrated and take breaks during peak heat. Dialysis centers have expanded, though access remains limited in remote areas, and economic challenges make treatment unaffordable for many.
Community education is gaining traction, teaching farmers about safer pesticide use and the importance of early screening. International researchers are collaborating with local experts to pinpoint CKDu’s causes, with recent studies highlighting climate change as a growing factor. Yet, the economic fallout from past crises, including the pandemic, has left Sri Lanka’s healthcare system stretched thin. Families like Subasinha’s often rely on loans or charity to survive, while patients like Sirani wait for transplants that may never come.
Hope for the Future
There’s still hope for curbing CKDu’s spread. Simple changes, like providing shaded rest areas and electrolyte drinks for farmers, could reduce heat stress. Stricter regulations on agrochemicals and better water purification systems are critical steps. Early detection through regular health check-ups can catch the disease before it’s too late. Sri Lanka’s resilience shines through in community efforts, where neighbors support each other and local leaders advocate for change.
For those searching for answers about kidney disease in Sri Lanka, the message is clear: awareness and prevention are key. If you’re in an affected area, test your drinking water, stay hydrated, and seek medical advice early. CKDu may be a silent epidemic, but with collective action, Sri Lanka can protect its young men and reclaim the health of its rural communities.