Abstract: “Chronic Kidney Disease due to unknown etiology (CKDu) is a deadly disease of which the prevalence have been identified in several countries in North Central America, India and Sri Lanka. Several studies have showed that, the usual factors as long-standing diabetes and hypertension are not the leading causes for the majority of CKD patients from the dry zone of Sri Lanka. Many researchers suggest that the etiology for CKDu may be a combination of several environmental factors. Some suggest that even though no single geochemical parameter could be clearly and directly related to the CKD etiology, it is very likely that the unique hydro-geochemistry of the drinking water is closely associated with the incidence of the disease. Hence this research was aimed to identify the CKDu prevalence in Sri Lanka and the similarities with the reported cases in the world, and to evaluate the suggested etiologies for the CKDu in Sri Lanka with more focus to the strong etiology suggestions. Initially a t”

Keywords: CKDu, Etiology, Groundwater Quality, Fluoride, Hardness