We have started the first community-based longitudinal study investigating the natural history of a new forms of chronic kidney disease of unknown origin and also call Mesoamerican Nephropathy in León and Chinandega departments, Nicaragua. 1001 apparently healthy young population aged 18-30 years old (M:F 5:1) without previous diagnose of diabetes mellitus, hypertension and /or kidney problems were recruited after performed community census.

This study design has several advantages. Firstly, this type of cohort represents the entire at-risk population because all males and females were included. Workers from all occupations were recruited. Secondly, the cohort studies dealing with the reverse-causation. Third, we can make comparison between and within persons.

The study visits take place annually where we collect a variety of exposure, e.g., socio-demographics data, current occupation, labour history, environmental exposure (heat exposure, pesticide, etc), infectious disease, healthy and unhealthy habits (water intake, alcohol consumption, smoking), dehydration symptoms, self-medication, etc.

Furthermore, we collected biological samples (blood and urine) from each study visit over 10 years of follow-up. Serum and urine aliquots were separate and storage in biobank at -80ºC. Also, water samples were collected during the dry and rainy season during the first year.

The samples have been analysing in different laboratories. For  example: Heavy metal and water quality was analysed at Imperial College London, serum creatinine and cystatin c at Nuffield Department of Population Health Wolfson Laboratories from the Clinical Trials Services Unit (CTSU), Oxford University, pesticide at laboratory at Occupational and Environmental Medicine (OEM) in Lund, kidney biomarkers (ACR and NGAL) at laboratory of Nephrology Center, UCL. and urinary metals and metaloids were measured at Health and Safety Environmental Laboratory.