Review Article JOURNAL OF THE COLLEGE OF COMMUNITY PHYSICIANS OF SRI LANKA

Results The disease mainly affects males from poor socio-economic backgrounds who are involved in paddy farming . Mild proteinuria was present but urinary sediments were normal. Renal biopsies were reported as interstitial nephritis. Significant predictors of kidney disease in these patients included age, history of smoking, being under treatment for hypertension and drinking well water in the fields. Studies on heavy metal and ochratoxin exposure have revealed conflicting results. Fluoride content of well water in all these areas exceeded the WHO recommended level of 0.6 mg/L. Water in all areas was alkaline which could facilitate mobilization of fluoride from minerals indicating a fluoride mediated mechanism for renal damage.