Impact of changing agricultural practices on human health: Chronic kidney disease of multi-factorial origin in Sri Lanka

Non-harmonious and unsustainable agricultural practices have major impact on the environment, causing animal and human diseases. Agriculture is an essential part of our lives. However, excessive use of agrochemicals, and irresponsible and harmful agricultural habits cause soil and water pollution, and secondary contamination of human food chain. Contamination of soil and water with toxic agrochemicals (e.g., phosphate fertilizer contaminated with heavy metals, pesticides and herbicides etc.) is a particular concern. These pollutants in water generally are in small quantities, and thus, cannot be seen or tasted. Therefore, their harmful effects do not manifest in humans for several years. During the past three decades, an escalating incidence of chronic kidney disease (CKD) of an unusual nature has manifested in agricultural dry-zonal areas in several tropical countries, including Sri Lanka, but no specific cause has been determined to-date. However, current evidence suggests that more than one component is involved in this geo-water-related preventable health epidemic; hence using the terminology, CKD of multi-factorial origin (CKD-mfo). Detrimental agricultural habits, including excessive and indiscriminate use of toxic agrochemicals, not using protective gear when using agrochemicals, drinking contaminated water from paddy fields and from contaminated shallow dugwells, and allowing continued environmental contamination, have led to the escalation of this deadly disease in these regions. The epidemic has detrimental effects not only on affected families, but also on the socio economic aspects of villages, the region, and the entire country. While providing clean water to villages, enhancing awareness and education, and preventing environmental pollution, each country that is affected with CKD-mfo (CKDu) must seek to identify and eliminate the root causes of the disease to prevent its progress, with a specific action plan to eliminate it. Unless corrective steps are taken in a timely and effective manner, the situation is likely to worsen drastically damaging their economies and the humanity. However, it is not too late to reverse this negative vicious cycle of death and destruction, and bring back prosperity to the region.