Research

We investigate an emerging syndemic, in which climate stressors such as heat and air pollution interact synergistically to amplify already rising chronic disease burdens across the kidneys and the brain.

Our framework

Central to our work is the bidirectional kidney–brain axis. Kidney dysfunction leads to the accumulation of uremic toxins that compromise neurocognitive health, while the brain's central regulation is vital for maintaining renal homeostasis. Our framework, published in The Lancet Planetary Health, positions the integrity of the intestinal barrier and the blood–brain barrier as convergence and amplification points through which climatic and environmental stressors might drive multi-organ vulnerability. These proposed mechanisms require validation in longitudinal human studies.

Research priorities

The framework identifies priorities including prospective cohort studies tracking climate-exposed populations over time, biomarker validation of gut and blood–brain barrier integrity, and targeted interventions to preserve gut–kidney–brain axis function alongside exposure reduction.

Policy actions

The most immediately actionable policy responses are upstream: reducing environmental exposures through emissions legislation, securing access to safe water and nutritious food, improving sanitation infrastructure, and implementing occupational heat protection such as shaded rest breaks and revised work–rest cycles.

Flagship publication

Selected publications by members

• Da Silva I, Calderón MEG, Peralta AD, Smolentzov I, Wikuats CFH, Roelofs JJTH, Florquin S, Sanches TR, Freitas ED, Kers J, Tammaro A, de Fatima Andrade M, Andrade L. Chronic PM2.5 exposure and increased risk of hospitalization for kidney disease in São Paulo, Brazil. Sci Rep · 2026. doi:10.1038/s41598-026-39558-5
• Rasking L, Vanbrabant K, Sun P, Vangeneugden M, Strauch M, Schins RPF, Cassee FR, Bové H, De Vusser K, Nawrot TS, Tammaro A, Boor P, Plusquin M. Kidney morphological changes associated with early-life carbonaceous ultrafine particle exposure: A pathomics approach. Environ Res · 2025. doi:10.1016/j.envres.2025.122458
• Giordano L, Ahmed S, van der Made TK, Masereeuw R, Mihăilă SM. Gut microbial-derived short chain fatty acids enhance kidney proximal tubule cell secretory function. Biomed Pharmacother · 2025. doi:10.1016/j.biopha.2025.118214
• Valderrama B, Calderón-Romero P, Bastiaanssen TFS, Lavelle A, Clarke G, Cryan JF. The South American MicroBiome Archive (saMBA). Nat Commun · 2025. doi:10.1038/s41467-025-62601-4
• Wagner CA, Frey-Wagner I, Ortiz A, et al. The role of the intestinal microbiome in cognitive decline in patients with kidney disease. Nephrol Dial Transplant · 2025. doi:10.1093/ndt/gfae253
• Zoccali C, Mallamaci F, Wagner CA, et al. Genetic and circulating biomarkers of cognitive dysfunction and dementia in CKD. Nephrol Dial Transplant · 2025. doi:10.1093/ndt/gfae259
• Tofani GSS, Leigh SJ, Gheorghe CE, et al. Gut microbiota regulates stress responsivity via the circadian system. Cell Metab · 2025. doi:10.1016/j.cmet.2024.10.003
• Bolignano D, Simeoni M, Hafez G, et al. Cognitive impairment in CKD patients: a guidance document by the CONNECT network. Clin Kidney J · 2024. doi:10.1093/ckj/sfae294
• Sanches TR, Parra AC, Sun P, et al. Air pollution aggravates renal ischaemia-reperfusion-induced acute kidney injury. J Pathol · 2024. doi:10.1002/path.6302
• Adalat S, Hajat S, Ikiz B. Climate change has serious implications for children's brain health. BMJ · 2024. doi:10.1136/bmj.q1588
• Ibanez A, Melloni L, Świeboda P, et al. Neuroecological links of the exposome and One Health. Neuron · 2024. doi:10.1016/j.neuron.2024.04.016