TY - JOUR
T1 - Environmental exposure assessment in the international prospective study of Chronic Kidney Disease of UnceRtain Etiology (CKDu) in Agricultural Communities (CURE) research consortium
T2 - Design and protocol development
AU - González-Quiroz, Marvin
AU - Aceituno, Anna
AU - Anand, Shuchi
AU - van Geen, Alexander
AU - Engel, Lawrence S.
AU - Jarquin, Emmanuel
AU - Ruepert, Clemens
AU - Villegas-González, Nicole
AU - Arias-Hidalgo, Mariela
AU - Franceschini, Nora
AU - Anchía-Pastrán, Daylin
AU - Solano-Diaz, Karla
AU - Corrales-Vargas, Andrea
AU - Crowe, Jennifer
AU - Cubilla-Batista, Idalina
AU - Acosta, Hildaura
AU - Mike, Adriana
AU - Guzmán-Quilo, Carolina
AU - Aragón, Aurora
AU - López-Bonilla, Indiana
AU - Rohloff, Peter
AU - Scammell, Madeleine K.
AU - Garcia-Trabanino, Ramón
AU - Velázquez, Juan Amador
AU - Brooks, Daniel R.
AU - Mohan, Sumit
AU - Radhakrishnan, Jai
AU - Gummidi, Balaji
AU - Jha, Vivekanand
AU - Collado, Whitney
AU - Bhalla, Vivek
AU - Friedman, David J.
AU - Waikar, Sushrut S.
AU - Kesler, Karen
AU - Trochinski, Lillian
AU - Ferguson, P. Lee
AU - Parsons, Patrick J.
AU - Hsu-Kim, Heileen
AU - Huset, Carin
AU - Summer Jenkins, Susan
AU - Mendley, Susan R.
AU - Lebov, Jill F.
AU - Joubert, Bonnie R.
AU - Navas-Acien, Ana
N1 - Publisher Copyright:
© 2025 The Authors
PY - 2025/6/25
Y1 - 2025/6/25
N2 - Background: Chronic kidney disease of unknown etiology (CKDu) is a major health concern among outdoor manual workers in rural Central America and South Asia. The CURE study is a prospective longitudinal cohort designed to investigate CKDu's environmental risk factors through standardized exposure assessments, questionnaires, and biological and environmental sample collection. Methods: This manuscript details the development of a standardized exposure assessment protocol within the CKDu CURE Consortium. The study recruits adults (18–45 years) from CKDu hotspots across five countries, ensuring proportional representation across three eGFR categories (20–59, 60–89, ≥90 mL/min/1.73m2) and excluding participants with diabetes or other known CKD causes. The CURE study is committed to promptly returning clinically and environmentally relevant test results to participants after analysis. Results: Exposure assessment includes demographics, healthcare access, nephrotoxic medications, infectious pathogens, and agricultural work conditions (e.g., heat stress, hydration, diet, agrochemicals, toxicants). Biological and environmental samples (water, dust, soil, wristbands) are collected considering seasonal variations. Omics analyses, including metabolomics, will investigate environmental and biological interactions. Statistical analyses will assess relationships between exposures and CKDu onset or progression, incorporating environmental mixture analyses. Conclusion: CURE will provide critical insights into CKDu risk factors, supporting future research and prevention strategies. A comprehensive exposure assessment will enhance understanding of environmental contributors, guiding interventions at individual, workplace, and community levels to mitigate CKDu's impact.
AB - Background: Chronic kidney disease of unknown etiology (CKDu) is a major health concern among outdoor manual workers in rural Central America and South Asia. The CURE study is a prospective longitudinal cohort designed to investigate CKDu's environmental risk factors through standardized exposure assessments, questionnaires, and biological and environmental sample collection. Methods: This manuscript details the development of a standardized exposure assessment protocol within the CKDu CURE Consortium. The study recruits adults (18–45 years) from CKDu hotspots across five countries, ensuring proportional representation across three eGFR categories (20–59, 60–89, ≥90 mL/min/1.73m2) and excluding participants with diabetes or other known CKD causes. The CURE study is committed to promptly returning clinically and environmentally relevant test results to participants after analysis. Results: Exposure assessment includes demographics, healthcare access, nephrotoxic medications, infectious pathogens, and agricultural work conditions (e.g., heat stress, hydration, diet, agrochemicals, toxicants). Biological and environmental samples (water, dust, soil, wristbands) are collected considering seasonal variations. Omics analyses, including metabolomics, will investigate environmental and biological interactions. Statistical analyses will assess relationships between exposures and CKDu onset or progression, incorporating environmental mixture analyses. Conclusion: CURE will provide critical insights into CKDu risk factors, supporting future research and prevention strategies. A comprehensive exposure assessment will enhance understanding of environmental contributors, guiding interventions at individual, workplace, and community levels to mitigate CKDu's impact.
KW - CKDu
KW - Chronic kidney disease
KW - Environmental exposures
KW - Metals
KW - Pesticides
KW - Polycyclic aromatic hydrocarbons
KW - Research consortium
KW - Trace elements
UR - https://www.scopus.com/pages/publications/105005502433
UR - https://www.scopus.com/pages/publications/105005502433#tab=citedBy
U2 - 10.1016/j.scitotenv.2025.179642
DO - 10.1016/j.scitotenv.2025.179642
M3 - Article
C2 - 40409020
AN - SCOPUS:105005502433
SN - 0048-9697
VL - 983
JO - Science of the Total Environment
JF - Science of the Total Environment
M1 - 179642
ER -