Study Protocol - Accurate assessment of kidney function in Indigenous Australians

aims and methods of the eGFR study

Louise Maple-Brown, Paul Lawton, Jaquelyne Hughes, Suresh Sharma, Graham Jones, Andrew G Ellis, Wendy Hoy, Alan Cass, Richard J MacIsaac, Ashim Sinha, Mark A B Thomas, Leonard S Piers, Leigh C Ward, Katrina Marie Drabsch, Sianna Panagiotopoulos, Robyn McDermott, Kevin Warr, Sajiv Cherian, Alexander Brown, George Jerums & 1 others Kerin O'Dea

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians.

    Methods/Design: A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history.

    Discussion: We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.
    Original languageEnglish
    Article number80
    Pages (from-to)80-90
    Number of pages11
    JournalBMC Public Health
    Volume10
    DOIs
    Publication statusPublished - 19 Feb 2010

    Fingerprint

    Glomerular Filtration Rate
    Kidney
    Somatotypes
    Western Australia
    Body Composition
    Northern Territory
    Queensland
    Chronic Renal Insufficiency
    Iohexol
    Medical Economics
    Diet Therapy
    Cystatin C
    Skinfold Thickness
    Photon Absorptiometry
    Kidney Diseases
    Electric Impedance
    African Americans
    Type 2 Diabetes Mellitus
    Population
    Creatinine

    Cite this

    Maple-Brown, Louise ; Lawton, Paul ; Hughes, Jaquelyne ; Sharma, Suresh ; Jones, Graham ; Ellis, Andrew G ; Hoy, Wendy ; Cass, Alan ; MacIsaac, Richard J ; Sinha, Ashim ; Thomas, Mark A B ; Piers, Leonard S ; Ward, Leigh C ; Drabsch, Katrina Marie ; Panagiotopoulos, Sianna ; McDermott, Robyn ; Warr, Kevin ; Cherian, Sajiv ; Brown, Alexander ; Jerums, George ; O'Dea, Kerin. / Study Protocol - Accurate assessment of kidney function in Indigenous Australians : aims and methods of the eGFR study. In: BMC Public Health. 2010 ; Vol. 10. pp. 80-90.
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    abstract = "Background: There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design: A cross-sectional study of Indigenous Australian adults (target n = 600, 50{\%} male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history. Discussion: We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.",
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    author = "Louise Maple-Brown and Paul Lawton and Jaquelyne Hughes and Suresh Sharma and Graham Jones and Ellis, {Andrew G} and Wendy Hoy and Alan Cass and MacIsaac, {Richard J} and Ashim Sinha and Thomas, {Mark A B} and Piers, {Leonard S} and Ward, {Leigh C} and Drabsch, {Katrina Marie} and Sianna Panagiotopoulos and Robyn McDermott and Kevin Warr and Sajiv Cherian and Alexander Brown and George Jerums and Kerin O'Dea",
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    Maple-Brown, L, Lawton, P, Hughes, J, Sharma, S, Jones, G, Ellis, AG, Hoy, W, Cass, A, MacIsaac, RJ, Sinha, A, Thomas, MAB, Piers, LS, Ward, LC, Drabsch, KM, Panagiotopoulos, S, McDermott, R, Warr, K, Cherian, S, Brown, A, Jerums, G & O'Dea, K 2010, 'Study Protocol - Accurate assessment of kidney function in Indigenous Australians: aims and methods of the eGFR study', BMC Public Health, vol. 10, 80, pp. 80-90. https://doi.org/10.1186/1471-2458-10-80

    Study Protocol - Accurate assessment of kidney function in Indigenous Australians : aims and methods of the eGFR study. / Maple-Brown, Louise; Lawton, Paul; Hughes, Jaquelyne; Sharma, Suresh; Jones, Graham; Ellis, Andrew G; Hoy, Wendy; Cass, Alan; MacIsaac, Richard J; Sinha, Ashim; Thomas, Mark A B; Piers, Leonard S; Ward, Leigh C; Drabsch, Katrina Marie; Panagiotopoulos, Sianna; McDermott, Robyn; Warr, Kevin; Cherian, Sajiv; Brown, Alexander; Jerums, George; O'Dea, Kerin.

    In: BMC Public Health, Vol. 10, 80, 19.02.2010, p. 80-90.

    Research output: Contribution to journalArticleResearchpeer-review

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    T1 - Study Protocol - Accurate assessment of kidney function in Indigenous Australians

    T2 - aims and methods of the eGFR study

    AU - Maple-Brown, Louise

    AU - Lawton, Paul

    AU - Hughes, Jaquelyne

    AU - Sharma, Suresh

    AU - Jones, Graham

    AU - Ellis, Andrew G

    AU - Hoy, Wendy

    AU - Cass, Alan

    AU - MacIsaac, Richard J

    AU - Sinha, Ashim

    AU - Thomas, Mark A B

    AU - Piers, Leonard S

    AU - Ward, Leigh C

    AU - Drabsch, Katrina Marie

    AU - Panagiotopoulos, Sianna

    AU - McDermott, Robyn

    AU - Warr, Kevin

    AU - Cherian, Sajiv

    AU - Brown, Alexander

    AU - Jerums, George

    AU - O'Dea, Kerin

    PY - 2010/2/19

    Y1 - 2010/2/19

    N2 - Background: There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design: A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history. Discussion: We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.

    AB - Background: There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design: A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history. Discussion: We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.

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