The endemic of chronic renal failure (CRF) emerged in 2002 in the farming provinces of Sri Lanka. An estimate of dietary cadmium intake was between 15 and 28 microg/kg body weight per week. The mean urinary cadmium in patients diagnosed with stage 5 kidney failure was 7.6 microg/g creatinine and 11.6 microg/g for asymptomatic persons.