Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults: the eGFR Study

Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults: the eGFR Study Journal Article

Nephrology

• Author(s): Hughes, J. T., Maple-Brown, L. J., Thomas, M., Lawton, P. D., Sinha, A., Cass, A., Barzi, F., Jones, G. R. D., Jerums, G., MacIsaac, R. J., O'Dea, K., Hoy, W. E.
• Published: 2018
• Volume: 23
• ISBN: 1440-1797

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Abstract: Objective: To describe the detailed associations of albuminuria among a contemporary cohort of Aboriginal and Torres Strait Islander people to inform strategies for chronic kidney disease prevention and management. Methods: A cross-sectional analysis of Indigenous participants of the eGFR Study. Measures: Clinical, biochemical and anthropometric measures were collected (including body-circumferences, blood pressure (BP); triglycerides, HbA1c, liver function tests, creatinine; urine- microscopic-haem, albumin: creatinine ratio (ACR), prescriptions- angiotensin converting enzyme inhibitor or angiotensin receptor II antagonist (ACEI/ARB). Albuminuria and diabetes were defined by an ACR>3.0 mg/mmol, and HbA1c≥48 mmol/mol or prior history respectively. Waist: hip ratio (WHR), and estimated glomerular filtration rate (eGFR) were calculated. ACR was non-normally distributed; a logarithmic transformation was applied (in base 2), with each unit increase in log2-albuminuria representing a doubling of ACR. Results: 591 participants were assessed (71% Aboriginal, 61.6% female, mean age 45.1 years, BMI 30.2 kg/m2, WHR 0.94, eGFR 99.2 ml/min/1.73m2). The overall prevalence of albuminuria, diabetes, microscopic-haem and ACEI/ARB use was 41.5%, 41.5%, 17.8% and 34.7% respectively; 69.3% of adults with albuminuria and diabetes received an ACEI/ARB. Using multivariable linear regression modelling, the potentially modifiable factors independently associated with log2-albuminuria were microscopic-haem, diabetes, WHR, systolic BP, alkaline phosphatase (all positive) and eGFR (inverse). Conclusion: Albuminuria is associated with diabetes, central obesity and haematuria. High ACEI/ARB prescribing for adults with diabetes and albuminuria was observed. Further understanding of the links between fat deposition, haematuria and albuminuria is required.

• Urls: http://dx.doi.org/10.1111/nep.12956