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: 10660996
• 负责人: Madeleine Scammell
• 金额: $ 34.98万
• 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/10660996
• 关键词: Acceleration; 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; Epidemiologic Research Design; 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 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; experience; high risk; high risk population; male; men; mortality; nephrotoxicity; progression risk; 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.

项目概要 中美洲流行慢性肾脏病（CKD），患病率已 过去 20 年来，萨尔瓦多和尼加拉瓜的肾病总体死亡率最高。 慢性肾病是世界上最常见的疾病，是美国工作年龄男性的第二大死因。 和欧洲一样，CKD 在老年人群（年龄 >60 岁）中很常见，对男性和女性的影响相同，并且主要是 相比之下，中美洲某些地区的 CKD 发病率不成比例。 影响年轻男性且似乎与糖尿病​​或高血压无关的农业工人最为常见。 受影响，但具体原因仍不清楚。类似的慢性肾病流行病尚不清楚。 斯里兰卡和印度存在病因学（CKDu），美国国立卫生研究院正在开展一项研究。 该联盟将汇集广泛的专业知识，使发现科学能够理解 该联盟还将努力确定潜在的治疗方法。 目标和公共卫生干预措施，将包括科学数据协调中心、现场 流行病学网站和肾脏科学核心联盟将共同努力最终确定伦理。 流行病学研究设计、执行生物采样和环境的共同策略 评估，对收集的样本和数据应用分析策略，并传播结果。这是一项提案。 萨尔瓦多和尼加拉瓜的现场流行病学站点。 我们的目标是： (1) 与 CURE 联盟指导委员会和 SDCC 一起制定研究方案，以进行 (2) 参与并同意最多 880 萨尔瓦多人 居住在有充分记录的高风险 CKDu 社区的尼加拉瓜参与者加入 CURE (3) 进行临床评估、采集生物和环境样本并进行管理 确定疾病状况和危险因素的调查问卷，以检验多种假设 （四）研究者之间进行多方位、持续的沟通 本地和国际利益相关者，包括将个人肾功能结果传达给 CURE 向队列、当地合作伙伴、科学界、公共卫生部门提供总体研究结果 我们的研究团队目前在这个主题上有着丰富的历史。 关联 慢性肾病估计是全球第 12 大死亡原因，肾脏“热点” 我们对中环地区受慢性肾病影响的高危人群进行了研究。 美国（肾脏疾病“热点”）将有助于科学认识肾脏疾病的环境影响因素 疾病的易感性和严重程度，特别关注预防和治疗的机会。