Studying "Forever Chemicals" and Kidney Health in Nicaragua
For more than two decades, doctors have been puzzled by a serious illness affecting rural Central America. Thousands of young, otherwise healthy adults, many of them agricultural workers, have developed chronic kidney disease without any of the usual risk factors such as diabetes or high blood pressure. Because the cause remains unidentified, researchers refer to the condition as chronic kidney disease of unknown etiology, or CKDu. The disease has been linked to more than 10,000 deaths in the past twenty years, and scientists suspect that environmental conditions play a role. Possible contributors include extreme heat, dehydration, pesticides, heavy metals, and contaminated drinking water.
A new study published in Scientific Reports investigated a different potential factor: per- and polyfluoroalkyl substances, better known as PFAS or "forever chemicals." These synthetic compounds have been manufactured since the 1940s and appear in nonstick cookware, waterproof fabrics, food packaging, cosmetics, and firefighting foam. Their chemical structure makes them extraordinarily stable, meaning they resist breaking down and accumulate in soil, water, and human blood over time. Previous research has associated PFAS exposure with elevated cholesterol, weakened immune response, thyroid and liver problems, reduced fertility, and increased risk of certain cancers. Laboratory studies also suggest PFAS may damage the kidneys, since these chemicals concentrate in kidney tissue as the organs filter blood.
Several authors of this study are faculty members in the Department of Environmental and Occupational Health at the Kate Marmion School of Public Health. They include Leanne S. Fawkes, Yau Adamu, David Gimeno Ruiz de Porras, and Marvin González-Quiroz, who served as the study's corresponding author. These faculty collaborated with colleagues from institutions in Spain and the United Kingdom, and the PFAS laboratory analysis was funded directly by the Department of Environmental and Occupational Health. Their participation demonstrates how public health researchers based in San Antonio are contributing to questions that affect communities worldwide.
The research team analyzed blood samples from 85 young adults between the ages of 18 and 30 living in northwestern Nicaragua. Participants were part of a long-running community health study that began in 2014. Using sophisticated laboratory equipment, scientists screened for 24 different PFAS compounds and detected six of them in more than half of the participants. Two compounds, PFOS and PFOA, were the most common, and concentrations tended to be higher in men than in women. Workers employed on banana plantations and in construction and commerce showed the highest levels overall, while unemployed participants showed the lowest. This research represents the first time PFAS levels have been measured in a population where CKDu is widespread, which makes the data a valuable starting point for future investigations.
As our faculty continue to study our local area, the biomonitoring methods and analytical approaches developed through this project can be applied to measure PFAS exposure and track kidney health among South Texas workers and residents, particularly outdoor and agricultural laborers who face comparable heat stress, chemical exposures, and water quality concerns right here at home.
Read the abstract and report at Scientific Reports:
Serum per- and polyfluoroalkyl substances levels among young adults at risk for chronic kidney disease of unknown etiology in Nicaragua
Author Profiles from the Kate Marmion School of Public Health: