Cause of CKD Epidemic in Sister City Remains a Mystery

 

Bruce Cohen, keynote speaker at the Annual Meeting of the Brookline-Quezalguaque  Sister City Project on November 14th began his presentation  by noting the international implications of the study underway in Nicaragua by a research team from the Boston University School of Public Health. Funded by the World Bank as part of an Alternative Dispute Resolution process between agricultural workers and a sugar cane grower, the B.U. research team is trying to identify the cause of an epidemic of Chronic Kidney Disease (CKD) impacting Quezalguaque and other regions of  Nicaragua but also parts of the Pacific Rim countries of El Salvador and Costa Rica.

Concentrated in males and centered in two western regions of Nicaragua that includes Quezalguaque,  CKD has been found to occur at relatively young ages in the impacted communities with rates of Stage 4/5 CKD more than 50 times that found in the U. S.   

Dr. Cohen’s presentation was based on a forum at the B.U. School of Public Health that brought World Bank  and Nicaraguan colleagues to Boston several weeks ago.  He credited the early work of the Sister City Health Committee in drawing attention to the CKD outbreak.  As members of the Health Committee, he and Daniel Brooks, the Principal Investigator of the CKD Project.  had begun investigating the cause of the epidemic more than four years ago.    In a subsequent interview, Dr. Brooks credited B.U.’s selection to his early involvement and research through Sister City.

In his presentation, Dr. Cohen said that the causes of the epidemic remain a “mystery”  and that  “diabetes and hypertension, the most common etiologies world-wide, do not seem to be the causes of the epidemic”  

The team has looked into the work processes of agricultural workers, the agrichemicals used on crops, and has screened water samples for contaminants known to cause CKD.  No cause was found.   Dr. Cohen concluded his presentation stating  “that this does not rule out the possibility that one or more chemical or other agents might be the cause of the epidemic but  new scientific knowledge and insights will be necessary to establish whether any link actually exists.”

In other business at the Annual Meeting, outgoing Sister City Co-President Carol Caro was saluted by newly elected President Richard Segan and Board member Frank Farlow for her many accomplishments including the growth of the library’s collection and programming, the shipment of  library and medical equipment and her tireless work on behalf of the Sister City Project including editing and producing the Sister City Project’s just released year-end newsletter.  Both Carol and Co-President Sarah Johnson  plan to stay active with Sister City.  Carol will be chairing a new fundraising committee; Sarah  a key contributor and liaison to Quezalguaque for many years will be leading an engagement meeting in January and continuing to serve on the Health Committee and Board.   Also elected at the Annual Meeting were Fran Price as Treasurer and Susan Morley as Secretary.

Dr. Peter Stringham will be chairing the Project’s Health Committee and attendees were invited to participate in the Sister City project through one of its committees, by joining a future trip to Quezalguaque, or by making a financial contribution. For more information, visit the Sister City website at www.brooklinesistercity.com or Richard Segan at rsegan@rcn.com.