Clinical outcomes associated with albuminuria in central Australia: a cohort study
| Autor: | Kevin G. Rowley, Alicia J. Jenkins, Kerin O'Dea, Mark Daniel, Rebecca Ritte, Robyn McDermott, Alex Brown, Joanne N Luke, James D. Best, Craig Nelson |
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| Přispěvatelé: | Ritte, Rebecca, Luke, Joanne, Nelson, Craig, Brown, Alex, O'Dea, Kerin, Jenkins, Alicia, Best, James D, McDermott, Robyn, Daniel, Mark, Rowley, Kevin |
| Jazyk: | angličtina |
| Předmět: |
Male
Nephrology Native Hawaiian or Other Pacific Islander rural and remote health medicine.medical_treatment 030204 cardiovascular system & hematology Aboriginal people 0302 clinical medicine Risk Factors Rural and remote health Longitudinal Studies 030212 general & internal medicine albumin creatinine ratio risk Aged 80 and over education.field_of_study Middle Aged Urology & Nephrology End stage renal disease 3. Good health Cardiovascular Diseases Creatinine Disease Progression Female medicine.symptom Cohort study Research Article Risk Adult medicine.medical_specialty Adolescent Population Urinalysis albuminuria Young Adult 03 medical and health sciences Predictive Value of Tests Renal Dialysis Internal medicine Diabetes Mellitus cohort study medicine Albuminuria Humans Obesity education end stage renal disease Dialysis Aged Proportional Hazards Models Retrospective Studies Waist-Hip Ratio business.industry Australia Albumin creatinine ratio Retrospective cohort study medicine.disease Kidney Failure Chronic business Kidney disease |
| Zdroj: | BMC Nephrology |
| ISSN: | 1471-2369 |
| DOI: | 10.1186/s12882-016-0328-1 |
| Popis: | Background Chronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia. Methods Cox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants’ baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia. Predictors of progression of albuminuria were also examined in the context of the Kidney Health Australia (KHA) Risk Matrix. Results A baseline ACR level of ≥3.5 mg/mmol was associated with an almost 10-fold increased risk of ESKD (95%CI 2.07-43.8) and a 15-fold risk of dialysis (95%CI 1.89-121). Albuminuria ≥3.5 mg/mmol was also associated with a borderline 63 % increased risk of CVD (95%CI 0.98-2.71). No significant association was observed with mortality from all-causes or chronic disease. Diabetes and a waist-to-hip ratio ≥0.90 independently predicted a two-fold increased risk of a progression to higher ACR levels. Conclusions A single measure of moderately increased albuminuria was a strong predictor of renal failure in this population. A single spot urine ACR analysis in conjunction with the KHA Risk Matrix may be a useful and efficient strategy to screen for risk of CKD and progression to dialysis in remote communities. A focus on individuals with diabetes and/or central obesity for strategies to avoid increases in albuminuria may also prevent future CKD and CVD complications. Electronic supplementary material The online version of this article (doi:10.1186/s12882-016-0328-1) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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