Progression of Kidney Disease in Indigenous Australians: The eGFR Follow-up Study
| Autor: | Rebecca Ritte, Graham R D Jones, Elizabeth Death, George Jerums, Louise J. Maple-Brown, Robyn McDermott, Paul D. Lawton, Richard J MacIsaac, Ashim Sinha, Sajiv Cherian, Alison Simmonds, Federica Barzi, Alex Brown, Alan Cass, Jaquelyne T. Hughes, Mark Thomas, Wendy E. Hoy, Kerin O'Dea |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty Longitudinal study Native Hawaiian or Other Pacific Islander Epidemiology Population 030232 urology & nephrology Renal function Critical Care and Intensive Care Medicine Young Adult 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine medicine Albuminuria Humans Longitudinal Studies 030212 general & internal medicine Renal Insufficiency Chronic education Aged Transplantation education.field_of_study Creatinine business.industry Australia Original Articles Middle Aged medicine.disease Confidence interval chemistry Nephrology Cohort Disease Progression Physical therapy Female medicine.symptom business Follow-Up Studies Glomerular Filtration Rate Kidney disease |
| Zdroj: | Clinical Journal of the American Society of Nephrology. 11:993-1004 |
| ISSN: | 1555-905X 1555-9041 |
| Popis: | Indigenous Australians experience a heavy burden of CKD. To address this burden, the eGFR Follow-Up Study recruited and followed an Indigenous Australian cohort from regions of Australia with the greatest ESRD burden. We sought to better understand factors contributing to the progression of kidney disease. Specific objectives were to assess rates of progression of eGFR in Indigenous Australians with and without CKD and identify factors associated with a decline in eGFR.This observational longitudinal study of Indigenous Australian adults was conducted in20 sites. The baseline cohort was recruited from community and primary care clinic sites across five strata of health, diabetes status, and kidney function. Participants were then invited to follow up at 2-4 years; if unavailable, vital status, progression to RRT, and serum creatinine were obtained from medical records. Primary outcomes were annual eGFR change and combined renal outcome (first of ≥30% eGFR decline with follow-up eGFR60 ml/min per 1.73 m(2), progression to RRT, or renal death).Participants (n=550) were followed for a median of 3.0 years. Baseline and follow-up eGFR (geometric mean [95% confidence interval], 83.9 (80.7 to 87.3) and 70.1 (65.9 to 74.5) ml/min per 1.73 m(2), respectively. Overall mean annual eGFR change was -3.1 (-3.6 to -2.5) ml/min per 1.73 m(2). Stratified by baseline eGFR (≥90, 60-89,60 ml/min per 1.73 m(2)), annual eGFR changes were -3.0 (-3.6 to -2.4), -1.9 (-3.3 to -0.5), and -5.0 (-6.5 to -3.6) ml/min per 1.73 m(2). Across baseline eGFR categories, annual eGFR decline was greatest among adults with baseline albumin-to-creatinine ratio (ACR)265 mg/g (30 mg/mmol). Baseline determinants of the combined renal outcome (experienced by 66 participants) were higher urine ACR, diabetes, lower measured GFR, and higher C-reactive protein.The observed eGFR decline was three times higher than described in nonindigenous populations. ACR was confirmed as a powerful predictor for eGFR decline across diverse geographic regions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|