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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Chronic Interstitial Nephritis in Agricultural Communities (CINAC) has emerged as an epidemic in several tropical countries over the past three decades, claiming thousands of lives. Evidence indicates that the disease is a toxic nephropathy in which nephrotoxins are primarily ingested through contaminated drinking water. The present authors played a pioneering role in introducing and promoting community-based, large and mediumscale reverse osmosis (RO) water purification systems in CKD-affected rural areas of Sri Lanka during 2011–2014. Previous studies have shown a continuous decline in CINAC incidence after more than 20% of families in endemic regions gained access to RO-treated drinking water.
A descriptive study was conducted to assess the relationship between the availability of RO-treated drinking water and the incidence of CINAC in the North Central Province (NCP), the main CINAC endemic region in Sri Lanka, from 2010 to 2024. Data on hospital-registered CINAC patients were collected, along with information on the installation and distribution of RO water plants, obtained through district and divisional secretariats, the Sri Lanka Navy, and community organisations. The number and locations of medium and large scale RO plants (village-level) were mapped across the NCP.
A steady increase in the establishment of RO plants was observed from 2012 onward. By the end of 2024, 82% of villages in the NCP (excluding Anuradhapura and Polonnaruwa municipal areas supplied by piped water) had access to RO-treated water. In total, 1,958 RO plants with a filtration capacity exceeding 2,000 L/day were operational, with 44% having a capacity greater than 5,000 L/day. The palatability of RO-treated water led to an increase in daily water consumption among residents. Between 2010 and 2024, a total of 32,888 newly diagnosed CINAC-compatible cases were reported in the NCP—20,657 in Anuradhapura and 12,231 in Polonnaruwa districts. A consistent decline in newly diagnosed cases was recorded across all divisional secretariat areas from 2016 onward, with some centres reporting zero new cases after 2020.
The transition from shallow well water to RO-treated water represents the most significant lifestyle change in CINAC-endemic regions. RO membranes, with their microscopic pores, allow only water molecules to pass through, effectively removing larger contaminants such as heavy metals and pesticide residues. The findings suggest that chronic exposure to nephrotoxins may require a cumulative threshold to induce renal damage, and reducing exposure below this threshold through RO filtration can prevent clinically manifestable disease. Moreover, RO-treated water is more palatable and promotes adequate hydration, addressing the risk of dehydration associated with hard water. Providing safe and ultra-clean drinking water has likely been the primary factor driving the continuous decline in CINAC incidence across the NCP. This shift in drinking water source can thus be considered a lifesaving public health intervention for rural Sri Lanka.
