CKDu in Salvadoran and Nicaraguan Agricultural Communities

萨尔瓦多和尼加拉瓜农业社区的 CKDu

• 批准号: 10471958
• 负责人: Madeleine Scammell
• 金额: $ 45.78万
• 依托单位: BOSTON UNIVERSITY MEDICAL CAMPUS
• 依托单位国家: 美国
• 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/10471958
• 关键词: Affect; Age; Agonist; Agricultural Workers; Agriculture; Air Pollution; Alcohols; Asia; Behavior; Behavioral; Biological; Boston; Cause of Death; Central America; Chemicals; Chronic Kidney Failure; Clinical assessments; Collaborations; Communication; Communities; Complex Mixtures; Consent; Country; Data; Data Coordinating Center; Dehydration; Developing Countries; Diabetes Mellitus; Diagnosis; Diet; Disease; Disease Progression; Disease susceptibility; Early Diagnosis; El Salvador; Elderly; Environment; Epidemic; Epidemiology; Epigenetic Process; Ethics; Etiology; Europe; Exposure to; Family member; Flame Retardants; General Population; Generations; Genetic Predisposition to Disease; Goals; Government; Heat Stress Disorders; Heavy Metals; Home; Hot Spot; Hypertension; India; Individual; Infectious Agent; Inherited; Injury to Kidney; International; Kidney; Kidney Diseases; Life Style; Nicaragua; Nicaraguan; Nutritional status; Occupational; Older Population; Participant; Pathology; Persons; Pharmaceutical Preparations; Population; Predisposition; Prevalence; Prevention; Procedures; Protocols documentation; Public Health; Questionnaires; Recording of previous events; Renal function; Research; Research Design; Research Personnel; Risk; Risk Factors; Salvadoran; Sampling; Science; Severity of illness; Site; Sri Lanka; Standardization; Time; Toxic effect; United States National Institutes of Health; Universities; Woman; Work; agricultural community; cohort; community based participatory research; design; drinking water; early onset; epidemiology study; experience; high risk; high risk population; male; men; mortality; nephrotoxicity; public health intervention; recruit; social; therapeutic target; trait; working men; young man

PROJECT SUMMARY There is an epidemic of chronic kidney disease (CKD) in Central America, and the prevalence has been increasing over the past 20 years. El Salvador and Nicaragua have the highest overall mortality rates from kidney disease in the world, and CKD is the second leading cause of mortality among men of working age. In the US and Europe, CKD is common in older populations (age>60), affects men and women equally, and is primarily due to diabetes and hypertension. In contrast, CKD in certain regions of Central America disproportionately affects younger men and appears to be unrelated to diabetes or hypertension. Agricultural workers are the most affected, but the specific cause(s) remains unknown. Similar epidemics of chronic kidney disease of unknown etiology (CKDu) exist in Sri Lanka and India. The US National Institutes of Health is establishing a research consortium that will bring together a broad range of expertise and enable discovery science to understand the cause or causes of CKDu and disease progression. The Consortium will also work to identify potential therapeutic targets and public health intervention and will consist of a Scientific Data Coordinating Center, Field Epidemiology Sites, and a Renal Science Core. The Consortium will work together to finalize ethical epidemiology research designs, execute common strategies for biological sampling and environmental assessment, apply analytic strategies for collected samples and data, and disseminate results. This is a proposal for a Field Epidemiology Site in El Salvador and Nicaragua. Our aims are: (1) Develop study protocol with the CURE Consortium Steering Committee and SDCC to conduct longitudinal research on the causes and progression of CKDu; (2) Engage and consent up to 880 Salvadoran and Nicaraguan participants residing in well-documented high-risk CKDu communities into the CURE Consortium; (3) Conduct clinical assessments, collect biological and environmental samples, and administer questionnaires to determine disease status and risk factors for the examination of multiple hypotheses longitudinally for three years; (4) Engage in multi-directional and sustained communication among investigators and stakeholders locally and internationally, including communicating individual kidney function results to CURE participants, and overall study results to cohort participants, local partners, the scientific community, public health officials, and the general public. Our study team currently has a strong history together on this topic. Relevance Chronic kidney disease is estimated to be the 12th leading cause of death globally, with “hot spots” of kidney disease with no known causes. Our study of a high-risk population affected by chronic kidney disease in Central America (kidney disease “hot spots”) will contribute to scientific understanding of environmental contributors of disease susceptibility and severity with a particular focus on opportunities for prevention and treatment.

项目摘要 中美洲有一种慢性肾脏疾病（CKD）流行，患病率一直是 在过去的20年中增加。萨尔瓦多和尼加拉瓜的肾脏总死亡率最高 世界上的疾病，CKD是工作年龄男性死亡率的第二大主要原因。在美国 和欧洲，CKD在老年人群中很常见（年龄> 60岁），对男人和女人平均影响，并且是主要的 由于糖尿病和高血压。相反，中美洲某些地区的CKD不成比例 农业工作者受年轻男性影响最大，似乎与糖尿病​​或高血压无关。 受影响，但特定原因仍然未知。类似的未知慢性肾脏疾病发作 斯里兰卡和印度存在病因（CKDU）。美国国家卫生研究院正在建立研究 联盟将汇集广泛的专业知识，并使发现科学能够了解 CKDU和疾病进展的原因或原因。该财团还将努力确定潜在的治疗 目标和公共卫生干预措施，将由科学数据协调中心组成 流行病学网站和肾科学核心。该财团将共同努力以最终确定道德 流行病学研究设计，执行生物抽样和环境的共同策略 评估，对收集的样品和数据应用分析策略，并传播结果。这是一个建议 对于萨尔瓦多和尼加拉瓜的现场流行病学地点。 我们的目的是：（1）与CURE财团指导委员会和SDCC一起制定研究方案，以执行 关于CKDU的原因和进展的纵向研究； （2）最多聘请并同意880萨尔瓦多 尼加拉瓜的参与者居住在有据可查的高风险CKDU社区中 财团； （3）进行临床评估，收集生物学和环境样本并管理 调查表，以确定疾病状况和危险因素检查多种假设 纵向三年； （4）调查人员之间进行多向和持续的沟通 以及在本地和国际上的利益相关者，包括传达单个肾功能结果以治愈 参与者和总体研究结果为队列参与者，当地合作伙伴，科学界，公共卫生 官员和公众。我们的学习团队目前在这个主题上共同拥有很强的历史。 关联 慢性肾脏疾病估计是全球死亡的第十二个主要原因，肾脏“热点” 没有已知原因的疾病。我们对中央慢性肾脏疾病影响的高风险人群的研究 美国（肾脏疾病“热点”）将有助于科学理解对环境的贡献者 疾病的敏感性和严重性，特别关注预防和治疗的机会。