India - Factors of CKDu in Uddanam Study (India-FOCUS)

印度 - Uddanam 研究中 CKDu 的因素 (India-FOCUS)

• 批准号: 10300864
• 负责人: Vivekanand Jha
• 金额: $ 56.56万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-08-25 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10300864
• 关键词: Address; Adult; Affect; Age; Agriculture; Air; Alcohols; Analgesics; Area; Biological Markers; Biopsy; Blood; Chronic Kidney Failure; Clinical; Cohort Studies; Collaborations; Collection; Communities; Country; Coupled; Cross-Sectional Studies; Data; Development; Diabetes Mellitus; Disease; Disease Progression; Dose; Ecology; Environment; Environmental Epidemiology; Environmental Exposure; Environmental Risk Factor; Environmental and Occupational Exposure; Etiology; Evaluation; Family; First Degree Relative; Frequencies; Future; Gender; General Population; Genes; Genetic; Genetic Predisposition to Disease; Glomerular Filtration Rate; Hair; Health system; Healthcare Systems; Heat Stress Disorders; Hematuria; Heterogeneity; Household; Hypertension; India; Individual; Infection; Injury; Injury to Kidney; Intervention; Kidney Diseases; Leadership; Location; Longitudinal Studies; Manuals; Measurement; Measures; Medical; Medical History; Nail plate; Non-Steroidal Anti-Inflammatory Agents; Occupational; Occupations; Participant; Pathway interactions; Patients; Pattern; Perception; Pesticides; Phenotype; Poison; Population; Prevalence; Prevention; Preventive; Proteinuria; Protocols documentation; Public Health; Questionnaires; Recording of previous events; Renal function; Research; Resources; Risk Factors; Sample Size; Sampling; Seasonal Variations; Silicones; Soil; Spouses; Standardization; State Government; Sustainable Development; Testing; Time; Tobacco smoking behavior; Translating; Urine; Visit; Water; Work; age group; agricultural community; case control; clinical examination; cohort; community engagement; design; disability; epidemiology study; experience; follow-up; genetic pedigree; genetic risk factor; kidney biopsy; longitudinal analysis; low socioeconomic status; member; mortality; multidisciplinary; patient subsets; phenotypic data; pollutant; programs; prospective; public health intervention; recruit; sample collection; sex; therapy design

Summary This proposal describes the formation of an experienced multidisciplinary team that is well equipped to complete a comprehensive field epidemiology study of chronic kidney disease of uncertain etiology (CKDu) in the endemic region of Uddanam in South India. This India-FOCUS (India- Factors of CKDu in Uddanam Study) team represents well-established experts in kidney disease, epidemiology environmental science, and project management as well as extensive experience in field work in low resource settings. The India-FOCUS team, who have long standing prior collaborations, will facilitate the successful establishment of a case control longitudinal study that includes 400 participants with CKDu and 800 controls with repeated visits every 9 months. The recruitment strategy for participants with CKDu is designed to allow for careful study of the known familial clustering by the inclusion of at least 100 families with 2 or more affected individuals. Recruited controls will be matched to cases by age, sex, location and occupation. Study participants will undergo careful phenotyping including a detailed medical history, exposure history, standardized validated questionnaires, detailed family pedigree charts, clinical examination. The study will collect biospecimens (blood, urine, hair, nails) from all participants at regular prespecified intervals to measure kidney function, biomarkers of kidney injury, and biomarkers of various environmental exposures (Aim 1a & 1b). A subset of patients will undergo detailed evaluation of heat stress and additional precise measurements of glomerular filtration rate. We will also implement a detailed environmental sample (air, water, soil, silicone bands) collection protocol that will parallel biospecimen collection to facilitate targeted and untargeted analyses of environmental exposures (Aim 2). The results of individual testing and environmental samples will be appropriately returned to the study participants and the community at appropriate time points to help inform the development of effective preventive and interventive measures (Aim 3). Study participants will be followed longitudinally and incident CKDu cases will be identified among the controls. Our study is designed to identify the genetics, exposome and gene-environmental interactions that represent the underlying etiology and risk factors for progression of CKDu. Community engagement will allow the development of sustainable interventions to reduce the burden of CKDu in these communities.

总结