A 16-year-old girl from the North Central Province returns home in school uniform. Her father, who was a rice farmer, passed away from CKDu in 2008; her mother is currently working in Kuwait to meet the financial needs of a single parent household. This young girl lives alone with her older 23-year-old sister. Economic challenges of chronic disease can spread the financial burden on to other family members and can influence migration and work patterns. Unless a CKDu patient has a kidney transplant, there is no cure for the disease. Therefore, CKDu often has an indirect, yet also significant impact, on family structure in mostly poor, agricultural communities the dry-zone regions of Sri Lanka.