Chronic kidney disease (CKD) is a significant cause of morbidity and mortality worldwide1. In many developing countries a considerable proportion of CKD remains unexplained by traditional risk factors. This is often called chronic kidney disease of unknown etiology (CKDu). CKDu is a diagnosis of exclusion, made when a patient fulfills the Kidney Disease Improving Global Outcomes (KDIGO) CKD criteria but without evidence of a recognized cause such as diabetes, hypertension, or glomerulonephritis2. Over the last decade CKDu has become a leading cause of death in Sri Lanka