The Chorotega CKDu Epidemiology Field Study

Chorotega CKDu 流行病学实地研究

基本信息

批准号：
10300149
负责人：
Mariela Arias-Hidalgo
金额：
$ 53.48万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-08-25 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10300149
关键词：
Acute Renal Failure with Renal Papillary Necrosis Address Affect Age Distribution Agricultural Workers Agriculture Biological Biological Markers Case-Control Studies Cessation of life Chemical Exposure Chemicals Child Chronic Kidney Failure Clinical Clinical assessments Collaborations Communities Community Health Community Physician Costa Rica County Data Data Coordinating Center Dietary Factors Disease Enrollment Environmental Exposure Environmental Health Environmental and Occupational Exposure Epidemic Epidemiology Ethical Issues Etiology Exposure to Family Family Study Foundations Frequencies Funding Future Genetic Predisposition to Disease Glomerular Filtration Rate Goals Government Officials Health Health Personnel Healthcare Heat Stress Disorders Human Individual Injury to Kidney Intervention Kidney Knowledge Language Liberia Life Style Measurement Measures Metals Methods Natural History Non-Steroidal Anti-Inflammatory Agents North Carolina Occupational Occupational Exposure Occupational Health Participant Patient Self-Report Pesticides Pharmaceutical Preparations Phenotype Policies Prevalence Prevention Prospective Studies Province Public Health Research Research Design Research Personnel Resources Risk Assessment Risk Factors Sampling Science Seasons Serum Sex Distribution Silicones Site Solid Time Universities Urine Vulnerable Populations Woman Work Workplace agricultural community base case control combustion product community based participatory research dietary drinking water epidemiology study field study kidney biopsy male predictive marker premature prospective recruit response safety and feasibility social urinary

Acute Renal Failure with Renal Papillary Necrosis Address Affect Age Distribution Agricultural Workers Agriculture Biological Biological Markers Case-Control Studies Cessation of life Chemical Exposure Chemicals Child Chronic Kidney Failure Clinical Clinical assessments Collaborations Communities Community Health Community Physician Costa Rica County Data Data Coordinating Center Dietary Factors Disease Enrollment Environmental Exposure Environmental Health Environmental and Occupational Exposure Epidemic Epidemiology Ethical Issues Etiology Exposure to Family Family Study Foundations Frequencies Funding Future Genetic Predisposition to Disease Glomerular Filtration Rate Goals Government Officials Health Health Personnel Healthcare Heat Stress Disorders Human Individual Injury to Kidney Intervention Kidney Knowledge Language Liberia Life Style Measurement Measures Metals Methods Natural History Non-Steroidal Anti-Inflammatory Agents North Carolina Occupational Occupational Exposure Occupational Health Participant Patient Self-Report Pesticides Pharmaceutical Preparations Phenotype Policies Prevalence Prevention Prospective Studies Province Public Health Research Research Design Research Personnel Resources Risk Assessment Risk Factors Sampling Science Seasons Serum Sex Distribution Silicones Site Solid Time Universities Urine Vulnerable Populations Woman Work Workplace agricultural community base case control combustion product community based participatory research dietary drinking water epidemiology study field study kidney biopsy male predictive marker premature prospective recruit response safety and feasibility social urinary

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项目摘要

ABSTRACT Chronic kidney disease of uncertain etiology (CKDu) has reached epidemic proportions in Costa Rica’s Guanacaste province (Chorotega region), where it has become a leading cause of premature death. CKDu has a high burden among young, male agricultural workers, but women and children are also affected, and its causes remain largely unknown. In response to the RFA for Field Epidemiology Sites for the Chronic Kidney Diseases of UnceRtain Etiology in Agricultural Communities Research Consortium (CURE Consortium), we propose to recruit, enroll and follow 400 participants with evidence of CKDu and 400 control participants for comprehensive assessments of individual risk factors and contextual exposures for CKDu. We propose an Epidemiology Field Center in Liberia, Chorotega region, as part of a collaboration among the University of North Carolina at Chapel Hill, the University of Costa Rica and local nephrologists in the Chorotega region. Our study design includes a large case-control study with nested substudies and state-of-the art exposure assessment methods to identify risk factors and cause(s) of CKDu. We will conduct clinical assessments and collect extensive biological and environmental/occupational samples and data. In addition to analysis of a wide range of self-reported lifestyle/demographic, environmental, and occupational factors and environmental measurements in the case-control study, we will conduct 1) a nested family study to assess familial aggregation/genetic susceptibility; 2) a prospective study among controls of serial targeted and non-targeted contemporary environmental/occupational chemical exposures (exposomics) measured in urine and drinking water in relation to measures of acute kidney injury (AKI) and new-onset CKDu; and 3) a prospective field study among a representative sample of controls employed in agriculture and construction to investigate seasonal workplace exposures through repeat measures of targeted and non-targeted chemical exposures (exposomics, including but not limited to pesticide, metals, and combustion products), assessed in urine and via silicone wristband samplers, in relation to measures of heat stress-related AKI. We propose to assemble a resource of sufficient breadth, depth and size to permit informative assessments of a wide range of risk factors, including environmental/occupational exposures and health contexts, with sufficient power to identify one or more causes of CKDu that could be targeted for prevention, intervention or policy.

抽象的不确定病因（CKDU）的慢性肾脏疾病已达到哥斯达黎加的流行比例瓜纳卡斯特省（Chorotega地区），它已成为过早死亡的主要原因。 ckdu有年轻的男性农业工人中的燃烧量很高，但妇女和儿童也受到影响，其原因在很大程度上是未知的。为了回应RFA的野外流行病学网站农业社区研究联盟（治疗联盟）中不确定病因的疾病，我们提议招募，入学和关注400名参与者，并有CKDU证据和400名对照参与者的参与者对CKDU的个人风险因素和上下文暴露的全面评估。我们建议一个在乔洛特加地区利比里亚的流行病学现场中心，作为大学合作的一部分北卡罗来纳州教堂山，哥斯达黎加大学和Chorotega地区的当地肾病学家。我们的研究设计包括一项大型病例对照研究，嵌套的取代和最先进的暴露评估方法以识别CKDU的危险因素和原因。我们将进行临床评估，收集广泛的生物学和环境/职业样本和数据。除了分析宽阔自我报告的生活方式/人口，环境和职业因素以及环境病例对照研究的测量，我们将进行1）嵌套家庭研究以评估家庭聚集/遗传敏感性； 2）在针对序列和非目标的对照中进行的前瞻性研究尿液和饮酒测得与急性肾脏损伤（AKI）和新发CKDU的测量有关的水； 3）一个潜在的领域在同意和施工中采用代表性的对照样本进行研究季节性工作场所通过重复测量目标化学暴露和非目标化学暴露（在尿液和通过硅胶腕带样品，与热应力相关的AKI的测量有关。我们建议组装一个足够广度，深度和大小的资源，以允许对广泛的风险因素进行信息的评估，包括环境/职业暴露和健康环境，并具有足够的能力来识别一个或可以针对预防，干预或政策的CKDU的更多原因。