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

Award Number: U01DK130046
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: COOPERATIVE AGREEMENT
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/01/2021
PERIOD OF PERFORMANCE END DATE: 06/30/2026

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


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $476,997 )
2025	2025	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	5	9/7/2025	NON-COMPETING CONTINUATION	$293,044
2025	2025	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	5	9/9/2025	SUPPLEMENT FOR EXPANSION	$183,953
2025	2024	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	4	3/21/2025	NON-COMPETING CONTINUATION	$0
														Subtotal = $476,997

Issue Date FY: 2024 ( Subtotal = $450,000 )
2024	2024	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	003	4	8/5/2024	NON-COMPETING CONTINUATION	$450,000
2024	2023	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	3	5/13/2024	NON-COMPETING CONTINUATION	$0
2024	2023	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	3	12/11/2023	NON-COMPETING CONTINUATION	$0
2024	2023	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	3	4/2/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $450,000

Issue Date FY: 2023 ( Subtotal = $358,755 )
2023	2023	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	3	7/7/2023	NON-COMPETING CONTINUATION	$358,755
2023	2023	UNIVERSIDAD NACIONAL	AVENIDA 1, CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	002	3	9/6/2023	NON-COMPETING CONTINUATION	$0
2023	2022	UNIVERSIDAD NACIONAL	AVENIDA 1 CALLE 9	HEREDIA				CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	2	12/15/2022	NON-COMPETING CONTINUATION	$0
														Subtotal = $358,755

Issue Date FY: 2022 ( Subtotal = $438,001 )
2022	2022	UNIVERSIDAD NACIONAL	AVENIDA 1 CALLE 9	HEREDIA	NULL			CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	001	2	9/8/2022	NON-COMPETING CONTINUATION	$438,001
2022	2021	UNIVERSIDAD NACIONAL	AVENIDA 1 CALLE 9	HEREDIA	HEREDIA			CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	11/9/2021	NEW	$0
														Subtotal = $438,001

Issue Date FY: 2021 ( Subtotal = $415,950 )
2021	2021	UNIVERSIDAD NACIONAL	AVENIDA 1 CALLE 9	HEREDIA	HEREDIA			CRI	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	8/27/2021	NEW	$415,950
														Subtotal = $415,950

Grand Total All Awards = $2,139,703

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

Award Number: U01DK130046

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: COOPERATIVE AGREEMENT

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/01/2021

PERIOD OF PERFORMANCE END DATE: 06/30/2026

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