# CKDu in Salvadoran and Nicaraguan Agricultural Communities

> **NIH NIH U01** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2024 · $86,778

## Abstract

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.

## Key facts

- **NIH application ID:** 11168018
- **Project number:** 3U01DK130057-04S1
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Madeleine Scammell
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $86,778
- **Award type:** 3
- **Project period:** 2021-08-25 → 2025-04-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/11168018

## Citation

> US National Institutes of Health, RePORTER application 11168018, CKDu in Salvadoran and Nicaraguan Agricultural Communities (3U01DK130057-04S1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/11168018. Licensed CC0.

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