The influence of birthweight, past poststreptococcal glomerulonephritis and current body mass index on levels of albuminuria in young adults

The multideterminant model of renal disease in a remote Australian Aboriginal population with high rates of renal disease and renal failure

Wendy E. Hoy, Andrew V. White, Bernard Tipiloura, Gurmeet R. Singh, Suresh Sharma, Hilary Bloomfield, Cheryl E. Swanson, Alison Dowling, David A. McCredie

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Background: Australian Aborigines in remote areas have very high rates of kidney disease, which is marked by albuminuria. We describe a 'multihit' model of albuminuria in young adults in one remote Aboriginal community.

Methods: Urinary albumin/creatinine ratios (ACRs) were measured in 655 subjects aged 15-39 years and evaluated in the context of birthweights, a history of 'remote' poststreptococcal glomerulonephritis (PSGN; ≥5 years earlier) and current body mass index (BMI). Birthweight had been <2.5 kg (low birthweight, LBW) in 25.4% of subjects and 22.8% had a remote history of PSGN.

Results: ACR levels rose with age. It exceeded the microalbuminuria threshold in 33.6% of subjects overall (25% of males and 45% of females). In multivariate models, birthweight (inversely), remote PSGN and current BMI were all independent predictors of ACR levels. The effects of birthweight and PSGN and their combination were expressed through amplification of ACR levels in relation to age and around the group median BMI of 20.8 kg/m2. In people with BMI <20.8 (57.8% of all males and 40.3% of the females), LBW and PSGN alone had minimal effects on ACR, but in combination they strikingly amplified ACR in relation to age. Those with BMI ≥20.8 (which included 42.2% of the males and 59.7% of the females) had higher ACR levels, and both LBW and a PSGN history, separately and in combination, were associated with striking further amplification of ACR in the context of age.

Conclusion: Much of the great excess of disease in this population is explained by high rates of the early life risk factors, LBW and PSGN. Their effects are expressed through amplification of ACR in the context of increasing age and are further moderated by levels of current body size. Both early life risk factors are potentially modifiable.

Original languageEnglish
Pages (from-to)971-977
Number of pages7
JournalNephrology Dialysis Transplantation
Volume31
Issue number6
DOIs
Publication statusPublished - 24 Jun 2016

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Albuminuria
Glomerulonephritis
Renal Insufficiency
Young Adult
Albumins
Creatinine
Body Mass Index
Kidney
Population
Oceanic Ancestry Group
Kidney Diseases
Body Size
Age Groups
History

Cite this

@article{cb1ad4da126f44988cea911f943ae930,
title = "The influence of birthweight, past poststreptococcal glomerulonephritis and current body mass index on levels of albuminuria in young adults: The multideterminant model of renal disease in a remote Australian Aboriginal population with high rates of renal disease and renal failure",
abstract = "Background: Australian Aborigines in remote areas have very high rates of kidney disease, which is marked by albuminuria. We describe a 'multihit' model of albuminuria in young adults in one remote Aboriginal community. Methods: Urinary albumin/creatinine ratios (ACRs) were measured in 655 subjects aged 15-39 years and evaluated in the context of birthweights, a history of 'remote' poststreptococcal glomerulonephritis (PSGN; ≥5 years earlier) and current body mass index (BMI). Birthweight had been <2.5 kg (low birthweight, LBW) in 25.4{\%} of subjects and 22.8{\%} had a remote history of PSGN. Results: ACR levels rose with age. It exceeded the microalbuminuria threshold in 33.6{\%} of subjects overall (25{\%} of males and 45{\%} of females). In multivariate models, birthweight (inversely), remote PSGN and current BMI were all independent predictors of ACR levels. The effects of birthweight and PSGN and their combination were expressed through amplification of ACR levels in relation to age and around the group median BMI of 20.8 kg/m2. In people with BMI <20.8 (57.8{\%} of all males and 40.3{\%} of the females), LBW and PSGN alone had minimal effects on ACR, but in combination they strikingly amplified ACR in relation to age. Those with BMI ≥20.8 (which included 42.2{\%} of the males and 59.7{\%} of the females) had higher ACR levels, and both LBW and a PSGN history, separately and in combination, were associated with striking further amplification of ACR in the context of age. Conclusion: Much of the great excess of disease in this population is explained by high rates of the early life risk factors, LBW and PSGN. Their effects are expressed through amplification of ACR in the context of increasing age and are further moderated by levels of current body size. Both early life risk factors are potentially modifiable.",
keywords = "Australian Aborigines, chronic kidney disease, low birthweight, multideterminant model, poststreptococcal glomerulonephritis",
author = "Hoy, {Wendy E.} and White, {Andrew V.} and Bernard Tipiloura and Singh, {Gurmeet R.} and Suresh Sharma and Hilary Bloomfield and Swanson, {Cheryl E.} and Alison Dowling and McCredie, {David A.}",
year = "2016",
month = "6",
day = "24",
doi = "10.1093/ndt/gfu241",
language = "English",
volume = "31",
pages = "971--977",
journal = "Nephrology Dialysis Transplantation",
issn = "0931-0509",
publisher = "Oxford University Press",
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}

The influence of birthweight, past poststreptococcal glomerulonephritis and current body mass index on levels of albuminuria in young adults : The multideterminant model of renal disease in a remote Australian Aboriginal population with high rates of renal disease and renal failure. / Hoy, Wendy E.; White, Andrew V.; Tipiloura, Bernard; Singh, Gurmeet R.; Sharma, Suresh; Bloomfield, Hilary; Swanson, Cheryl E.; Dowling, Alison; McCredie, David A.

In: Nephrology Dialysis Transplantation, Vol. 31, No. 6, 24.06.2016, p. 971-977.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - The influence of birthweight, past poststreptococcal glomerulonephritis and current body mass index on levels of albuminuria in young adults

T2 - The multideterminant model of renal disease in a remote Australian Aboriginal population with high rates of renal disease and renal failure

AU - Hoy, Wendy E.

AU - White, Andrew V.

AU - Tipiloura, Bernard

AU - Singh, Gurmeet R.

AU - Sharma, Suresh

AU - Bloomfield, Hilary

AU - Swanson, Cheryl E.

AU - Dowling, Alison

AU - McCredie, David A.

PY - 2016/6/24

Y1 - 2016/6/24

N2 - Background: Australian Aborigines in remote areas have very high rates of kidney disease, which is marked by albuminuria. We describe a 'multihit' model of albuminuria in young adults in one remote Aboriginal community. Methods: Urinary albumin/creatinine ratios (ACRs) were measured in 655 subjects aged 15-39 years and evaluated in the context of birthweights, a history of 'remote' poststreptococcal glomerulonephritis (PSGN; ≥5 years earlier) and current body mass index (BMI). Birthweight had been <2.5 kg (low birthweight, LBW) in 25.4% of subjects and 22.8% had a remote history of PSGN. Results: ACR levels rose with age. It exceeded the microalbuminuria threshold in 33.6% of subjects overall (25% of males and 45% of females). In multivariate models, birthweight (inversely), remote PSGN and current BMI were all independent predictors of ACR levels. The effects of birthweight and PSGN and their combination were expressed through amplification of ACR levels in relation to age and around the group median BMI of 20.8 kg/m2. In people with BMI <20.8 (57.8% of all males and 40.3% of the females), LBW and PSGN alone had minimal effects on ACR, but in combination they strikingly amplified ACR in relation to age. Those with BMI ≥20.8 (which included 42.2% of the males and 59.7% of the females) had higher ACR levels, and both LBW and a PSGN history, separately and in combination, were associated with striking further amplification of ACR in the context of age. Conclusion: Much of the great excess of disease in this population is explained by high rates of the early life risk factors, LBW and PSGN. Their effects are expressed through amplification of ACR in the context of increasing age and are further moderated by levels of current body size. Both early life risk factors are potentially modifiable.

AB - Background: Australian Aborigines in remote areas have very high rates of kidney disease, which is marked by albuminuria. We describe a 'multihit' model of albuminuria in young adults in one remote Aboriginal community. Methods: Urinary albumin/creatinine ratios (ACRs) were measured in 655 subjects aged 15-39 years and evaluated in the context of birthweights, a history of 'remote' poststreptococcal glomerulonephritis (PSGN; ≥5 years earlier) and current body mass index (BMI). Birthweight had been <2.5 kg (low birthweight, LBW) in 25.4% of subjects and 22.8% had a remote history of PSGN. Results: ACR levels rose with age. It exceeded the microalbuminuria threshold in 33.6% of subjects overall (25% of males and 45% of females). In multivariate models, birthweight (inversely), remote PSGN and current BMI were all independent predictors of ACR levels. The effects of birthweight and PSGN and their combination were expressed through amplification of ACR levels in relation to age and around the group median BMI of 20.8 kg/m2. In people with BMI <20.8 (57.8% of all males and 40.3% of the females), LBW and PSGN alone had minimal effects on ACR, but in combination they strikingly amplified ACR in relation to age. Those with BMI ≥20.8 (which included 42.2% of the males and 59.7% of the females) had higher ACR levels, and both LBW and a PSGN history, separately and in combination, were associated with striking further amplification of ACR in the context of age. Conclusion: Much of the great excess of disease in this population is explained by high rates of the early life risk factors, LBW and PSGN. Their effects are expressed through amplification of ACR in the context of increasing age and are further moderated by levels of current body size. Both early life risk factors are potentially modifiable.

KW - Australian Aborigines

KW - chronic kidney disease

KW - low birthweight

KW - multideterminant model

KW - poststreptococcal glomerulonephritis

UR - http://www.scopus.com/inward/record.url?scp=84975137614&partnerID=8YFLogxK

U2 - 10.1093/ndt/gfu241

DO - 10.1093/ndt/gfu241

M3 - Article

VL - 31

SP - 971

EP - 977

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 6

ER -