Study I (2011 and 2015)

In 2011, we enrolled 240 students ages 12-17 who attended four secondary schools in three different locations in Nicaragua. Schools were selected to represent different levels of CKD mortality in adults, as a proxy for risk for kidney damage in adolescents. In descending order of risk, schools were in Chichigalpa (two schools: one where parents mainly worked in the sugarcane industry and one where parents mainly worked in other settings), Masaya, and Jinotega. We conducted analyses of four urinary biomarkers of kidney damage (NAG, NGAL, IL-18, and albumin-creatinine ratio/ACR) among 200 participants evenly divided by school, sex, and age (12-14, 15-17). We found that biomarker levels were generally higher in girls than in boys and that NAG and NGAL displayed a positive dose-response relationship, especially among boys, with the highest concentrations in the schools designated as highest risk (Ramirez Rubio, 2015).

In 2015, we re-contacted and collected blood, urine, and saliva from 175 of the 200 participants on whom we had previously conducted analyses of biomarker levels. Analysis of this follow-up is ongoing.

We are currently in the process of conducting a metabolomic analysis on 170 paired baseline and follow-up samples in collaboration with the Center for Cooperative Research in Biosciences (CIC bioGUNE) in Spain.

Funding: Funding for the enrollment and sample and data collection of the baseline and follow-up study was provided by the Comité Nacional de Productores de Azúcar (CNPA), an association of sugar producers in Nicaragua. Funding for the metabolomic analysis was provided by the Fundación Renal Iñigo Alvarez de Toledo (FRIAT) in Spain. Donors have no influence over the design or outcomes of the research and BU is free to publish all findings.

Publications: Ramírez-Rubio O, Amador JJ, Kaufman JS, Weiner DE, Parikh CR, Khan U, McClean MD, Laws RL, López-Pilarte D, Friedman DJ, Kupferman J, & Brooks DR (2016). Urine biomarkers of kidney injury among adolescents in Nicaragua, a region affected by an epidemic of chronic kidney disease of unknown aetiology. Nephrology, Dialysis, Transplantation, 31(3), 424–432.