# The Chorotega CKDu Epidemiology Field Study

> **NIH NIH U01** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $534,848

## Abstract

ABSTRACT
Chronic kidney disease of uncertain etiology (CKDu) has reached epidemic proportions in Costa Rica’s
Guanacaste province (Chorotega region), where it has become a leading cause of premature death. CKDu has
a high burden among young, male agricultural workers, but women and children are also affected, and its
causes remain largely unknown. In response to the RFA for Field Epidemiology Sites for the Chronic Kidney
Diseases of UnceRtain Etiology in Agricultural Communities Research Consortium (CURE Consortium), we
propose to recruit, enroll and follow 400 participants with evidence of CKDu and 400 control participants for
comprehensive assessments of individual risk factors and contextual exposures for CKDu. We propose an
Epidemiology Field Center in Liberia, Chorotega region, as part of a collaboration among the University of
North Carolina at Chapel Hill, the University of Costa Rica and local nephrologists in the Chorotega region. Our
study design includes a large case-control study with nested substudies and state-of-the art exposure
assessment methods to identify risk factors and cause(s) of CKDu. We will conduct clinical assessments and
collect extensive biological and environmental/occupational samples and data. In addition to analysis of a wide
range of self-reported lifestyle/demographic, environmental, and occupational factors and environmental
measurements in the case-control study, we will conduct 1) a nested family study to assess familial
aggregation/genetic susceptibility; 2) a prospective study among controls of serial targeted and non-targeted
contemporary environmental/occupational chemical exposures (exposomics) measured in urine and drinking
water in relation to measures of acute kidney injury (AKI) and new-onset CKDu; and 3) a prospective field
study among a representative sample of controls employed in agriculture and construction to investigate
seasonal workplace exposures through repeat measures of targeted and non-targeted chemical exposures
(exposomics, including but not limited to pesticide, metals, and combustion products), assessed in urine and
via silicone wristband samplers, in relation to measures of heat stress-related AKI. We propose to assemble a
resource of sufficient breadth, depth and size to permit informative assessments of a wide range of risk factors,
including environmental/occupational exposures and health contexts, with sufficient power to identify one or
more causes of CKDu that could be targeted for prevention, intervention or policy.

## Key facts

- **NIH application ID:** 10300149
- **Project number:** 1U01DK130044-01
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Mariela Arias-Hidalgo
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $534,848
- **Award type:** 1
- **Project period:** 2021-08-25 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10300149

## Citation

> US National Institutes of Health, RePORTER application 10300149, The Chorotega CKDu Epidemiology Field Study (1U01DK130044-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10300149. Licensed CC0.

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