LOKI: Loiasis-associated chronic kidney disease – towards clinical recognition and policy action | LOKI | Proyecto | Ficha informativa | HORIZON | CORDIS

Objetivo

Chronic Kidney Disease (CKD) is an urgent but underrecognized health challenge in Central Africa, where diagnostic capacity is limited and renal replacement therapy is rare. While established drivers such as HIV, hypertension, and diabetes are acknowledged, the contribution of neglected tropical diseases remains unexplored. Loiasis, caused by the filarial parasite Loa loa and endemic in forested rural zones where >30% of adults are infected, has long been considered benign. Yet decades of case reports suggest renal complications, from proteinuria to renal failure. Preliminary findings from the ERC-funded MORLO cohort indicate that up to 15% of CKD in endemic populations may be attributable to loiasis, with a clear dose-response relationship between L. loa microfilarial density and kidney dysfunction. The LOKI project proposes the first systematic proof of concept to establish causality between loiasis and CKD. By integrating renal biopsies, histopathological characterization, biomarker analyses, and epidemiological associations, LOKI will move beyond correlation to provide mechanistic evidence. This translational framework bridges clinical observation, pathology, and population-level epidemiology, fulfilling the Bradford Hill biological plausibility criterion. If successful, it will demonstrate that parasitic infection is a neglected determinant of CKD, a paradigm shift in global kidney health. The innovation lies in reframing loiasis from a benign infection to a significant driver of chronic non-communicable disease. The project will deliver the first atlas of loiasis-associated kidney lesions, generate context-specific clinical guidelines, and produce advocacy briefs for ministries of health and the WHO. By providing actionable tools for clinicians, health systems, and policymakers, LOKI combines high-risk complexity with transformative potential: improved patient care, evidence-based prevention, and global recognition of loiasis as a neglected tropical disease.