Marvin Gonzalez Quiroz, MD, PhD Secures $30k for Chronic Kidney Disease of Unknown Etiology Research
Marvin A Gonzalez Quiroz, MD, PhD, MSc, Assistant Professor in the Department of Environmental and Occupational Health in the UT School of Public Health San Antonio, has successfully secured a $30,000 grant from the Medical Research Council in the United Kingdom to support the 10th year of follow-up fieldwork for a community-based cohort study on chronic kidney disease of unknown etiology (CKDu) in Nicaragua. This award is expected to significantly contribute to the ongoing efforts to unravel the environmental causes of CKDu and develop effective preventive interventions.
CKDu, a form of Chronic Kidney Disease (CKD) predominantly affecting the tubular-interstitial region of the kidney, has reached epidemic levels in agricultural communities across Mesoamerica and south Asia. Known as CKDu, Mesoamerican Nephropathy, and Chronic Interstitial Nephritis in Agricultural Communities, this disease poses a severe threat to the country's workforce and has been linked to the premature deaths of tens to hundreds of thousands of individuals across low-and-middle income countries.
The Nicaragua Prospective Community-based Cohort Study, established in 2014 in Nicaragua, aims to investigate the progression and causes of CKDu. The study focuses on potential links to environmental changes and agricultural practices, examining the effects of exposure to metals and metalloids, agrochemicals, infectious agents, and extreme heat due to dehydration. A recent publication from this study revealed a CKD incidence rate among young adults that is 25 times higher than in a comparable U.S. population. This early sustained kidney function loss aligns with the initial stages of Mesoamerican nephropathy and the associations with systemic upset and weight loss, independently of occupation, support a possible unidentified cause of the disease.
The research in Nicaragua is part of a larger effort that includes studies in South India and Sri Lanka, all following a standardized protocol. Comprehensive exposure data is being collected through direct measurements and detailed questionnaires. The goal is to extend participant follow-up to at least four years and expand the cohort to 1000 individuals. This will provide more robust data, helping to identify early biomarkers of the disease and genetic factors influencing kidney function decline over time. These findings will not only enhance understanding of the CKDu epidemic in Nicaraguan but also offer insights into whether similar health crises in Central America and South Asia share common causes or differ fundamentally.