4 Causative factors Since the identification of the epidemic of CKDu a number of health mapping studies environmental studies and human biological studies have been conducted to explore the possible causative factors According to most of the available research the general hypothesis is that the CKDu epidemic is related to the environment in particular environmental changes induced through human activities such as agriculture Due to the patchy geographical distribution of the disease it is often suspected to be related to the contamination of local drinking water sources Rajapakse et al 2016 Although the available research support the hypothesis that CKDu is and environmentally acquired disease no definitive causative factor have been identified so far Thus it is often considered to have a multifactorial etiology Wanigasuriya 2014 Rajapakse et al 2016 Some shallow wells in villages located below the water table can be often exposed to seepage of water from nearby irrigation systems developed for agriculture Communities that source drinking water from such wells are more affected by CKDu than the communities that depend on wells that do not get exposed to seepage
