Exploring risk factors and predictors of endemic CKDu in agricultural regions of four Central America countries

探索四个中美洲国家农业区地方性 CKDu 的风险因素和预测因素

基本信息

批准号：
10700868
负责人：
Jennifer Crowe
金额：
$ 35.88万
依托单位：
UNIVERSIDAD NACIONAL, COSTA RICA
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：
2021-09-01 至 2026-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10700868
关键词：
Acute Renal Failure with Renal Papillary Necrosis Agrochemicals Area Authorization documentation Biological Markers Biopsy Blood Case/Control Studies Central America Central American Chronic Kidney Failure Collaborations Collection Communities Costa Rica Country Coupled DNA DNA sequencing Data Deposition Detection Disease Disease Progression Dryness Electron Microscopy Enrollment Environment Environmental Exposure Environmental and Occupational Exposure Epidemiology Etiology Exposure to Factor Analysis Family Fever Genetic Glomerular Filtration Rate Guatemala Health Health Personnel Healthcare Systems Heat Stress Disorders Heavy Metals Histopathology Immunoglobulin G Immunoglobulin M Incidence Individual Infectious Agent Injury to Kidney Institution Kidney Longitudinal cohort Low Birth Weight Infant Malnutrition Manuals Mass Spectrum Analysis Measurement Measures Metals Morphology Natural History Nicaragua Panama Patients Poverty Proteinuria Public Health RNA Renal Tissue Renal function Research Rest Risk Risk Factors Risk Marker Role Rural Saccharum Silicon Dioxide Site Specimen Spottings Tissues Toxic Environmental Substances Toxin Tubular formation United States National Institutes of Health Universities Visit Work Zoonoses acronyms agricultural activity agricultural community agricultural region authority biobank case control design experience fighting follow-up genetic risk assessment genetic risk factor kidney biopsy member novel novel marker pathogen population based programs prospective rural area social determinants transcriptome sequencing vector-borne working men young adult

项目摘要

PROJECT SUMMARY Chronic kidney disease of unknown origin (CKDu) is highly prevalent in several tropical regions, including Central America where it is most common among young adult males working in sugarcane and other agricultural activities. It has taken a terrible toll on families living in vulnerable conditions in rural areas. Despite efforts to study CKDu over the last two decades, its causes are not fully understood and the disease continues to claim lives and overwhelm healthcare systems. This project aims to identify risk factors and predictors for estimated glomerular filtration rate (eGFR) decline among young individuals with and without CKDu in rural endemic areas in four Central American countries: Costa Rica, Panama, Nicaragua and Guatemala. We will comprehensively assess multiple risk factors related to 1) strenuous manual labor under heat stress with inadequate rest; 2) social determinants (e.g., poverty, malnutrition, low birth weight); 3) vector-borne or zoonotic diseases; and 4) exposure to known or novel toxins (e.g., heavy metals, agrochemicals, silica). We will also collect bio-banked specimens to assess genetic risk factors and novel biomarkers of acute kidney injury (AKI), as determined by the NIH Chronic Kidney Diseases of Uncertain Etiology (CURE) consortium. As a Field Epidemiology Site, our primary study aims are: (a) identification of cases and controls in endemic agricultural communities; (b) longitudinal follow-up of both cases and controls; and (c) biopsies in a subset of individuals. Our proposal takes advantage of the SALTRA network (Central American Program for Health, Work and Environment). SALTRA has nearly 20 years of experience conducting research in the region and has longstanding relationships with local communities, organizations and governmental organizations, public health authorities and local nephrologists on the front lines of fighting this disease.

项目概要不明原因慢性肾病 (CKDu) 在一些热带地区非常流行地区，包括中美洲，在年轻成年男性中最常见从事甘蔗和其他农业活动。它给家庭带来了可怕的损失农村地区生活条件脆弱。尽管过去两年努力研究 CKDu 几十年来，其原因尚未完全明了，这种疾病继续夺去生命，压垮医疗保健系统。该项目旨在确定风险因素和预测因素估计有或没有的年轻人肾小球滤过率（eGFR）下降 CKDu 在四个中美洲国家农村流行地区：哥斯达黎加、巴拿马、尼加拉瓜和危地马拉。我们将综合评估多种风险因素 1）热应激下的剧烈体力劳动且休息不足； 2）社会决定因素（例如贫困、营养不良、低出生体重）； 3) 媒介传播或人畜共患疾病；和 4) 接触已知或新型毒素（例如重金属、农用化学品、二氧化硅）。我们也会收集生物库样本以评估遗传风险因素和急性急性发作的新型生物标志物肾损伤 (AKI)，由 NIH 病因不明的慢性肾脏病确定 (CURE) 财团。作为现场流行病学网站，我们的主要研究目标是：(a) 确定流行农业社区的病例和控制措施； (b) 纵向案件和控制的后续行动； (c) 对一部分个体进行活组织检查。我们的该提案利用了 SALTRA 网络（中美洲健康计划，工作和环境）。 SALTRA 拥有近 20 年的研究经验该地区与当地社区、组织和机构有着长期的关系政府组织、公共卫生当局和当地肾脏病专家奋战在前线对抗这种疾病的路线。