Early Life Exposures
Investigation of Kidney Damage in Children and Adolescents
Chronic Kidney Disease of non-traditional etiology (CKDnt) is often characterized by onset in young adulthood, which distinguishes this disease from traditional CKD that is typically associated with older age. The heightened prevalence of CKDnt among young adults in Central America led us to hypothesize that early life exposures – those that occur in childhood, prior to working life – may play a role in the initiation and progression of the disease.
In June 2020, we published research identifying diminished renal function, kidney injury and hyperfiltration in youth without work history in Nicaragua, suggesting that kidney disease may originate before occupational exposures occur. Globally, CKD affects children with a prevalence of 1.5 to 3.0 per 1,000,000. Our work indicates that as many as 30 Nicaraguan children per 1,000,000 experience low eGFR consistent with CKD, which is more than 10-times higher than these global estimates. These data indicate that pediatric kidney disease is a significant, understudied problem in Nicaragua. Our goal is to comprehensively assess early markers of kidney disease among youth in Nicaragua and identify pre-occupational exposures associated with early-onset kidney disease or injury.
Our team began studying kidney health among children and adolescents in Nicaragua in 2011. To date, we have recruited over 800 young people in Nicaragua in a longitudinal study of kidney health among youth in this region of high-risk for CKDnt, the Jovenes-Nica Study.
Early Life Exposures studies to date: