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Title: Contribution of cardiometabolic risk factors to estimated glomerular filtration rate decline in Indigenous Australians with and without albuminuria - the eGFR Follow-up Study.
Austin Authors: Barr, Elizabeth L M;Barzi, Federica;Hughes, Jaquelyne T;Jerums, George ;O'Dea, Kerin;Brown, Alex Dh;Ekinci, Elif I ;Jones, Graham R D;Lawton, Paul D;Sinha, Ashim;MacIsaac, Richard J;Cass, Alan;Maple-Brown, Louise J
Affiliation: Menzies School of Health Research, Darwin, North Territory, Australia
Diabetes and Endocrinology, Cairns Base Hospital, Cairns, Australia
Nutrition and Population Health, University of South Australia, Adelaide, South Australia, Australia
Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
Department of Medicine, Royal Darwin Hospital, Darwin, North Territory, Australia
Sansom Institute Health Research, University of South Australia, Adelaide, South Australia, Australia
Department of Medicine, University of New South Wales, Sydney, Australia
St Vincent's Hospital, Melbourne, Melbourne, Victoria, Australia
Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
SydPath, St Vincent's Hospital, Sydney, New South Wales, Australia
South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
Department of Endocrinology, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Jul-2018
Publication information: Nephrology 2018; 23(7): 682-689
Abstract: We assessed associations between cardiometabolic risk factors and estimated glomerular filtration rate (eGFR) decline according to baseline albuminuria to identify potential treatment targets in Indigenous Australians. The eGFR Follow-up Study is a longitudinal cohort of 520 Indigenous Australians. Linear regression was used to estimate associations between baseline cardiometabolic risk factors and annual Chronic Kidney Disease Epidemiology Collaboration eGFR change (mL/min per 1.73m2 /year), among those classified with baseline normoalbuminuria (urine albumin-to-creatinine ratio (uACR) <3 mg/mmol; n = 297), microalbuminuria (uACR 3-30 mg/mmol; n = 114) and macroalbuminuria (uACR ≥30 mg/mmol; n = 109). After a median of 3 years follow-up, progressive declines of the age- and sex-adjusted mean eGFR were observed across albuminuria categories (-2.0 [-2.6 to -1.4], -2.5 [-3.7 to -1.3] and -6.3 [-7.8 to -4.9] mL/min per 1.72m2 /year). Although a borderline association was observed between greater baseline haemoglobin A1c and eGFR decline in those with macroalbuminuria (P = 0.059), relationships were not significant in those with microalbuminuria (P = 0.187) or normoalbuminuria (P = 0.23). Greater baseline blood pressure, C-reactive protein, waist-to-hip ratio and lower high-density lipoprotein cholesterol showed non-significant trends with greater eGFR decline in the presence of albuminuria. Over a 3 year period, marked eGFR decline was observed with greater baseline albuminuria. Cardiometabolic risk factors were not strong predictors for eGFR decline in Indigenous Australians without albuminuria. Longer follow-up may elucidate the role of these predictors and other mechanisms in chronic kidney disease progression in this population.
DOI: 10.1111/nep.13073
ORCID: 0000-0001-8058-6977
Journal: Nephrology
PubMed URL: 28503768
Type: Journal Article
Subjects: Indigenous
chronic kidney disease (CKD)
diabetes mellitus
haemoglobin A1c
Risk Factors
Appears in Collections:Journal articles

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