Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults

the eGFR Study

J. T. Hughes, L. J. Maple-Brown, M. Thomas, P. D. Lawton, A. Sinha, A. Cass, F. Barzi, G. R.D. Jones, G. Jerums, R. J. MacIsaac, K. O'Dea, W. E. Hoy

    Research output: Contribution to journalArticleResearchpeer-review

    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/1.73 m2). 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.
    Original languageEnglish
    Pages (from-to)37-45
    Number of pages9
    JournalNephrology
    Volume23
    Issue number1
    DOIs
    Publication statusPublished - 1 Jan 2018

    Fingerprint

    Albuminuria
    Glomerular Filtration Rate
    Creatinine
    Waist-Hip Ratio
    Albumins
    Heme
    Hematuria
    Blood Pressure
    Abdominal Obesity
    Angiotensin Receptor Antagonists
    Liver Function Tests
    Disease Management
    Chronic Renal Insufficiency
    Angiotensin-Converting Enzyme Inhibitors
    Prescriptions
    Alkaline Phosphatase
    Linear Models
    Triglycerides
    Cross-Sectional Studies
    Fats

    Cite this

    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. / Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults : the eGFR Study. In: Nephrology. 2018 ; Vol. 23, No. 1. pp. 37-45.
    @article{a907928ad4054dc187b9bea2c67b0c52,
    title = "Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults: the eGFR Study",
    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/1.73 m2). 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.",
    author = "Hughes, {J. T.} and Maple-Brown, {L. J.} and M. Thomas and Lawton, {P. D.} and A. Sinha and A. Cass and F. Barzi and Jones, {G. R.D.} and G. Jerums and MacIsaac, {R. J.} and K. O'Dea and Hoy, {W. E.}",
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    Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults : the eGFR Study. / 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.

    In: Nephrology, Vol. 23, No. 1, 01.01.2018, p. 37-45.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Cross-sectional associations of albuminuria among Aboriginal and Torres Strait Islander adults

    T2 - the eGFR Study

    AU - Hughes, J. T.

    AU - Maple-Brown, L. J.

    AU - Thomas, M.

    AU - Lawton, P. D.

    AU - Sinha, A.

    AU - Cass, A.

    AU - Barzi, F.

    AU - Jones, G. R.D.

    AU - Jerums, G.

    AU - MacIsaac, R. J.

    AU - O'Dea, K.

    AU - Hoy, W. E.

    PY - 2018/1/1

    Y1 - 2018/1/1

    N2 - 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/1.73 m2). 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.

    AB - 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/1.73 m2). 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.

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