them from further complications and progression into severe stages of the disease. Studies on the estimates of people's knowledge of CKDu and their ability to identify the disease early and seek treatment are unknown in Sri Lanka. Knowledge is measured in this study comprises information acquired from authoritative sources such as the local health department. The items of knowledge displayed in posters and educational sessions were used to construct the questionnaire of 67 knowledge items. Methods: The study used a descriptive, cross-sectional design to identify patients' knowledge and at-risk behaviors in the Medirigiriya DS division in Polonnaruwa District. The randomly obtained sample of 200 families was from 12 agricultural settlements in six Grama Niladhari (GN) divisions. A team of seven research assistants and the author conducted qualitative research, and 200 semi-structured interviews. The interviews were conducted with the chief householder or their spouse, who gave their verbal consent. The interviews were conducted in Sinhalese and translated into English. The questionnaire data were computer entered and analyzed in SPSS. Textual data were analyzed in the Atlas/Ti program for textual data analysis. Results: The mean knowledge score was 36.1 (S.D 7.76) for 178 families which, when converted to a percentage, was 42.3%. The CKDu knowledge scores increased as the age of patients increased (P 0.05). It shows that older patients were more knowledgeable of CKDu. The total knowledge score and socioeconomic status are significantly correlated (r.191 at the 0.05 level -two-tail test). Knowledge was lower among the old, less educated, low-income families and paddy farmers who owned paddy land less than 1 acre. Almost every interviewee was aware that a blood test should be done to identify CKDu. None of the respondents correctly answered all the 67 items of the knowledge questionnaire. 28.5% (n = 57) of the participants answered 42 to 50 questions correct, 35% (n=71) respondents answered 39 to 41 answers correct, and 34% (n=68) answered 8 to 32 questions correct. Furthermore, 86% (n =172) of the participants knew that the kidneys make urine, 64.5% (n=129) knew that kidneys clean blood, but only 17.5% (n=35) knew kidneys help regulate blood sugar, 15.5% (n=31) knew that kidneys help regulate blood pressure and breakdown proteins in the blood. Most participants did not know that CKDu can help prevent its progression into severe stages if identified in the initial stages. 72.5% (n=145) believed that identifying CKDu in a person is like getting a death certificate, but 90.5% (n=181) viewed that medications could slow down the disease's progression. Therefore, well over 90% of CKDu patients attend hospitals and clinics to get medications. Conclusions: Despite the high prevalence of CKDu among middle-aged rice paddy farmers, most respondents in the endemic areas knew very little about the disease, its causation, and treatment. The findings show that more community programs are needed to educate the people in the lower ...

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