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",
    number = "6",

    }

    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 -