Thushara Hewageegana
Consultant Chemical Pathologist, Sri LankaPresentation Title:
Chronic kidney disease of unknown origin in Sri Lanka
Abstract
Sri Lanka is a small tropical island situated in the
Indian ocean south to the Indian subcontinent. A rise of the incidence of Chronic
Kidney Disease(CKD) was reported from the dry zone of the country in 1990s
which was not attributed to the traditional causes of CKD. Therefore, it was
named as chronic kidney disease of unknown origin (CKDu). The disease is more
prevalent among farming communities and has a unique geographical distribution.
Agrochemicals, heavy metals, fluoride, hard water, algae, fungal toxins,
alcohol and betel chewing, irrigational networks and even bioterrorism as a
possible etiology has been considered. Though majority of the researchers
agreed on a toxic nephropathy, none of their hypothesis so far could explain
the clinical, biochemical, histopathological findings, and the unique
geographical distribution of the disease and its appearance in the mid-1990s.
Absence of an identifiable cause has hampered planning of prevention and
treatment of the disease.
Biography
Thushara Hewageegana is a consultant chemical pathologist at the Teaching Hospital Anuradhapura and a visiting lecturer at Rajarata University in Sri Lanka. He obtained his MBBS from the University of Colombo in 1998, followed by a diploma in pathology in 2008 and an MD in chemical pathology in 2012 from the Postgraduate Institute of Medicine, University of Colombo. He is a co-author of the "Screening guidelines for chronic kidney disease" (2017) and the study on the "Prevalence of Chronic Kidney Disease of Unknown Aetiology and Its Risk Factors in the District of Anuradhapura" (2017), both published by the Epidemiology Unit of the Ministry of Health, Sri Lanka. Additionally, he is the principal author of the chapter "Chronic kidney disease of unknown origin in Sri Lanka" in the book Chronic kidney disease: Novel insights into pathophysiology and treatment.
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