Environmental and molecular drivers of chronic kidney disease of non-traditional origin

Agricultural workers in tropical regions suffer from a high burden of chronic kidney disease of non-traditional origin (CKDnt), with occupational heat stress increasingly seen as causative. Another potential contributing cause is agrochemicals, but no specific ones have been identified. Previous studies on toxins have had low exposure assessment quality and statistical power.

The large number of possible contributing toxic causes of CKDnt call for novel approaches which can identify previously overlooked environmental factors interacting with physiological changes induced by heat stress.The overall aim of the project is to identify biological mechanisms through which environmental factors may cause CKDnt, with a focus on the interplay between heat, toxicants and gut-derived metabolites.

Improved understanding of the pathways between environmental factors and CKDnt can improve CKDnt prevention and promote climate resilience.Over the past five years, while collaborating with a large agroindustrial employer in Nicaragua on a heat stress intervention study, we have biobanked thousands of serum and urine samples among 1345 sugarcane workers.

With an extremely high CKDnt incidence in the region and longitudinal observations, this study is uniquely well suited to investigate a broad range of environmental factors, including exposome-metabolome interactions, potentially contributing to CKDnt.