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Title: Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults: the eGFR Study.
Austin Authors: Hughes, J T;Maple-Brown, L J;Thomas, M;Lawton, P D;Sinha, A;Cass, A;Barzi, F;Jones, Grd;Jerums, George ;MacIsaac, R J;O'Dea, K;Hoy, W E
Affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia
Department of Medicine, Royal Darwin Hospital, Darwin, Northern Territory, Australia
Royal Perth Hospital, Perth, Australia
Cairns Base Hospital and Diabetes Centre, Cairns, Australia
SydPath, St Vincent's Hospital, Sydney, Australia
University of Melbourne, Melbourne
Austin Health
Department of Endocrinology and Diabetes, St Vincent's Hospital, Melbourne
Centre for Population Health Research, Australia
Centre for Chronic Disease, The University of Queensland, Australia
Issue Date: Jan-2018
Publication information: Nephrology 2018; 23(1): 37-45
Abstract: 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. A cross-sectional analysis of Indigenous participants of the eGFR Study. 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. 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). 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.
DOI: 10.1111/nep.12956
ORCID: 0000-0002-1867-4156
Journal: Nephrology
PubMed URL: 29250918
Type: Journal Article
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