Genetic Case-Control Family Study | PI: Daniel Brooks and David Friedman
Through this case-control study, we seek to find genetic modifiers of CKD risk. We will recruit 360 agricultural workers with CKD but without traditional risk factors (e.g. diabetes, HIV, hepatitis, etc.) from Chinendega province, Nicaragua and 360 healthy controls matched for age and job description. We will perform a candidate gene association study using coding variants within loci identified in our family based genetic study of Mesoamerican Nephropathy.
Adolescent Cross-Sectional Study | PI: Daniel Brooks
This study is designed to determine whether children and adolescents aged 7-17 attending schools located in different geographical areas of Nicaragua (chosen based on different population CKD mortality rates, climate, altitude, and primary industry of the region, as well as parents’ occupation) show signs of kidney injury before they start working, and whether the extent of injury varies by school.
Longitudinal Investigation of Chronic Kidney Disease among Workers in El Salvador (Outstanding New Environmental Scientist (ONES) Award) | PI: Madeleine Scammell
This longitudinal investigation of Mesoamerican Nephropathy in El Salvador will allow us to address multiple pressing research questions in an attempt to further elucidate the cause(s) of the epidemic while simultaneously developing a repository of data and biological samples in order to quickly and efficiently address new hypotheses as they emerge.
Family-Based Study | PI: David Friedman
In order to analyze potential genetic causes of CKD, investigators are recruiting approximately 20 families with at least two siblings who have CKD. Interviews of family members will allow us to construct family trees that include the relationships between family members (e.g., child, parent, spouse, brother), CKD diagnosis, and whether the member of the family is presently alive.
Investigation of Risk Factors and Prevalence of MeN among Brick Makers | Collaboration between UNAN-León and BUSPH Team
To analyze risk factors of Mesoamerican Nephropathy (MeN) and to determine the prevalence of chronic kidney disease (CKD) among brick-makers in Western Nicaragua, investigators recruited 257 workers and completed interviews and biological sampling. Working with students and faculty at UNAN-León, this collaborative investigation built on their previous work studying CKD among laborers in the Nicaraguan artisanal brick industry.
Chronic Kidney Disease in Central America Research Group
There is an epidemic of chronic kidney disease (CKD) in Central America with increasing mortality rates over the past 20 years. Due to its unique characteristics, the disease has been referred to by some researchers as Mesoamerican Nephropathy (MeN) and CKD of nontraditional (CKDnt) or unknown etiology (CKDu). The CKD epidemic is considered a major public health threat by the Pan American Health Organization (PAHO)1 and declared a priority by the Commission of National Ministries of Health of Central America (COMISCA)2.
In the US and Europe, CKD is common only 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. CKD epidemics with strikingly similar characteristics are also found in other tropical regions including Sri Lanka and India. In all of these areas, agricultural workers appear to be among the groups most affected, but the specific cause(s) remain unknown.
Our team has been investigating the CKD epidemic since 2009.
1 152nd Executive Committee Session, 2013
2 XXXVII Meeting of COMISCA , May 2013
The 2nd International Workshop on the Epidemic of Mesoamerican Nephropathy (MeN) took place in San José, Costa Rica in November 2015 and the experts that attended collectively wrote the technical report. Read the report here: MeN 2015 Scientific Report.