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Kidney disease of unknown aetiology (CKDu) has been identified in manycountries extending from MesoAmerica and Egypt, to South-east Asia and China.Although CKDu has been linked by various authors to farming, it is an artifactof treating multi-modal disease distributions as unimodal. There is NOcorrelation of CKDu with agriculture since affected farming villages are oftensurrounded by other farming villages free of CKDu. Initial studies looked for acorrelation of CKDu with toxic heavy metal residues of arsenic, cadmium etc.,or herbicides like glyphosate that may be present in the environment, as thecausative factors. There is now considerable consensus that theirconcentrations are below danger thresholds, be it in Mesoamerica or south-eastAsia. The conceptual basis of a search for etiology within a systems approachis discussed, and attempts to name the disease to bias the identification ofits etiology are reviewed. Current research has narrowed down the etiology togeochemical electrolytic contaminants like fluorides and ionic components inhard water, nanosilica (found in water as well as in the air), as well as renaltoxins similar to indoxyl sulphates that may arise from interactions of ionswith humic acids contained in aqueous organic matter. However, whileagrochemical toxins are increasingly considered less relevant to the etiologyof CKDu, it has become a firm public belief. In Sri Lanka this has spawnedideology-based agricultural policies for partial and complete banning ofagrochemicals (2014-2021), followed by some back-tracking, disrupting theeconomy and the food supply. A farmer's uprising in 2022 was spawned by poorharvests. It triggered a larger popular uprising that led to the collapse of agovernment wedded to romanticized eco-extremist agricultural policies in acountry already facing difficulties in the wake of Covid and Ukraine.

Chronic Kidney Disease of Unknown Aetiolgy (CKDu)-the search for causes and the impact of its politicization