Chronic Kidney disease of uncertain etiology (CKDu) has become a significant disease burden, affecting farming community of Sri Lanka and the exact etiology, which could be multifactorial, is not hitherto established. This study is aimed to determine the association of past hantavirus infection and leptospirosis with the occurrence of CKDu. A cohort (n = 179) of known CKDu patients living in high-CKDu prevalent areas of Anuradhapura district of Sri Lanka was compared with a group of 49 healthy, sex-matched younger blood relatives of CKDu patients (control-1) and another 48 healthy, age, and sex-matched individuals living in low-CKDu prevalent area (control-2) of the same district where same life style and climate conditions prevail. Fifty out of 179 (27.9%) CKDu patients, 16/49 (32.7%) of control-1 and 7/48 (14.6%) of control-2 were found positive for IgG antibodies to Puumala, Hantaan or both strains of hantaviruses. Hantaan strain specificity was found to be predominant in all study groups. Hantavirus IgG sero-prevalence of healthy individuals living in low-CKDu prevalent area was significantly lower compared to CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas (p = 0.03). Past hantavirus infection possesses a significant risk for the occurrence of CKDu (OR = 4.5; 95% CI-3.1-5.4, p = 0.02). In contrast, IgG seroprevalence to hantaviruses was not significantly different in CKDu patients and healthy younger blood relatives living in high-CKDu prevalent areas indicating past hantavirus infection has no association with the occurrence of CKDu or possibly, younger relatives may develop CKDu in subsequent years. Seroprevalence to leptospirosis showed no significant difference between CKDu patients and healthy controls.

病因不明的慢性肾脏病（CKDu）已成为严重的疾病负担，影响了斯里兰卡的农业社区，迄今为止尚未确定可能是多因素的确切病因。这项研究旨在确定过去的汉坦病毒感染和钩端螺旋体病与CKDu的发生之间的关系。同类群组（ñ= 179）将居住在斯里兰卡阿努拉德普勒地区高CKDu流行区的已知CKDu患者与一组49名健康，性别匹配的CKDu患者的年轻血亲（对照组1）和另外48名健康的年龄进行了比较，以及生活在相同生活方式和气候条件相同地区的低CKDu流行区（对照2）中的性别匹配个体。在179名（27.9％）CKDu患者中，有50名对照1/16/49（32.7％）和对照2 7/48（14.6％）被发现对Puumala，汉坦病毒或两种汉坦病毒株的IgG抗体均为阳性。发现汉坦菌株的特异性在所有研究组中均占主导地位。p= 0.03）。过去的汉坦病毒感染具有发生CKDu的重大风险（OR = 4.5； 95％CI-3.1-5.4，p= 0.02）。相比之下，CKDu患者和生活在高CKDu流行地区的健康年轻血亲的汉坦病毒的IgG血清阳性率没有显着差异，这表明过去的汉坦病毒感染与CKDu的发生没有关系，或者可能是年轻的亲戚在随后的几年中可能发展为CKDu。钩端螺旋体病的血清阳性率在CKDu患者和健康对照之间没有显着差异。