Follow-Up Study of Chronic Kidney Disease in Quezalguaque, Nicaragua: 2015-2017

Since 1985, the Brookline-Quezalguaque Sister City Committee (BQSCC) has had a close relationship with the municipality of Quezalguaque, located in the northwest region of Nicaragua. In the early 2000s, town health officials informed the BQSCC of a number of excess deaths due to chronic kidney disease. Since that time, and working with few funds, the Health Committee of the BQSCC has conducted a number of activities in an attempt to contribute to an understanding of the cause of the disease. In 2008, the BQSCC sent students from BUSPH and BUMC to Quezalguaque to conduct a combined seroprevalence and case-control study. Researchers from UNAN-León provided critical assistance. The seroprevalence and case-control report from the study can be accessed on Pub Med.

Researchers from the BU team, students from BUSPH, and members of the BQSCC conducted a follow-up during the summer of 2015 to learn what had happened to participants from the 2008 study. Students from BUSPH and BUMC contacted approximately 250 of the original 771 participants in order to determine mortality, progression, and regression among participants who had an eGFR<60 and new cases among participants whose creatinine was within normal limits through collection of biological samples, questionnaire data, and medical records review. We also characterized factors associated with more rapid progression the diseased incidence disease those previously considered unaffected. A second follow-up directed by the BU team took place in spring 2016. There have been almost no studies that have characterized the effect of the CKD epidemic in communities over a period of time; this study will contribute to an understanding of the natural history of the disease and hopefully identify factors that can inform future interventions to slow progression of disease and prevent new cases among the residents of Quezalguaque and beyond.