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Prevalence, risk factors and awareness of albuminuria on a Canadian First Nation: a community-based screening study.

Zacharias JM, Young TK, Riediger ND, Roulette J, Bruce SG - BMC Public Health (2012)

Bottom Line: Of participants with diabetes, 42% (56/132) had albuminuria compared to 26% (7/27) among those with impaired fasting glucose and 10% (30/303) among those with normal glucose tolerance.Only 5.3% of those with albuminuria were aware of any degree of renal disease.The independent association between BMI and albuminuria has not been previously reported among indigenous populations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Nephrology, Department of Internal Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba R3A 1R9, Canada. jzacharias@exchange.hsc.mb.ca

ABSTRACT

Background: Both diabetic and non-diabetic end stage renal disease (ESRD) are more common among Canadian First Nations people than among the general Canadian population. The purpose of this research was to determine the prevalence of and risk factors for albuminuria in a Canadian First Nation population at high risk for ESRD and dialysis.

Methods: Data from a community-based screening study of 483 residents of a Plains Ojibway First Nation in Manitoba was used. Participants provided random urine samples. Proteinuria was defined as any dipstick positive for protein (≥1 g/L) or those with ACR in the macroalbuminuric range (≥30 mg/mmol) on at least one sample. Microalbuminuria was defined as ACR ≥2 mg/mmol for males and ≥2.8 mg/mmol for females. Other measures included fasting glucose, haemoglobin A1c, triglycerides, cholesterol, blood pressure, height, weight and waist and hip circumferences.

Results: Twenty percent of study participants had albuminuria, (5% proteinuria and 15% microalbuminuria). Of participants with diabetes, 42% (56/132) had albuminuria compared to 26% (7/27) among those with impaired fasting glucose and 10% (30/303) among those with normal glucose tolerance. Only 5.3% of those with albuminuria were aware of any degree of renal disease. In a multivariate logistic regression, independent associations with albuminuria were male gender [p = 0.002], increasing fasting glucose [p <0.0001], years diagnosed with diabetes [p = 0.03], increasing systolic blood pressure [p = 0.009], and increasing body mass index (BMI) [p = 0.04].

Conclusions: The independent association between BMI and albuminuria has not been previously reported among indigenous populations. There is a high prevalence of albuminuria in this Canadian First Nation population; the high proportion of patients with diabetes and undiagnosed kidney disease demonstrates the need for screening, education and intervention to halt the progression and development of albuminuria and ultimately ESRD and CVD.

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Percent albuminuria by age categories. There is a significant linear association between age group and proportion of those with albuminuria (p < 0.001). ‘n’ refers to the total number of participants in respective age category.
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Figure 1: Percent albuminuria by age categories. There is a significant linear association between age group and proportion of those with albuminuria (p < 0.001). ‘n’ refers to the total number of participants in respective age category.

Mentions: Participants with and without albuminuria are compared in Table 3. Those with albuminuria were older (p < 0.001) and albuminuria prevalence progressively increased with age (Figure 1). Men were more likely to have albuminuria than women (p = 0.01). Interestingly, those with albuminuria were less likely to report ever having smoked (p = 0.007). However, neither years of smoking nor pack-years smoked were significantly different between groups. Participants with albuminuria were more likely to be hypertensive by any measure. Seventy percent (70%) of those with albuminuria had hypertension compared with 36% of those without albuminuria (p < 0.0001). In this regard, mean blood pressures were significantly higher in the group with albuminuria compared to those without. Target blood pressure in those with albuminuria is generally recommended to be <130/80 mm Hg, however, this was achieved in only 34% of those with albuminuria.


Prevalence, risk factors and awareness of albuminuria on a Canadian First Nation: a community-based screening study.

Zacharias JM, Young TK, Riediger ND, Roulette J, Bruce SG - BMC Public Health (2012)

Percent albuminuria by age categories. There is a significant linear association between age group and proportion of those with albuminuria (p < 0.001). ‘n’ refers to the total number of participants in respective age category.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3403871&req=5

Figure 1: Percent albuminuria by age categories. There is a significant linear association between age group and proportion of those with albuminuria (p < 0.001). ‘n’ refers to the total number of participants in respective age category.
Mentions: Participants with and without albuminuria are compared in Table 3. Those with albuminuria were older (p < 0.001) and albuminuria prevalence progressively increased with age (Figure 1). Men were more likely to have albuminuria than women (p = 0.01). Interestingly, those with albuminuria were less likely to report ever having smoked (p = 0.007). However, neither years of smoking nor pack-years smoked were significantly different between groups. Participants with albuminuria were more likely to be hypertensive by any measure. Seventy percent (70%) of those with albuminuria had hypertension compared with 36% of those without albuminuria (p < 0.0001). In this regard, mean blood pressures were significantly higher in the group with albuminuria compared to those without. Target blood pressure in those with albuminuria is generally recommended to be <130/80 mm Hg, however, this was achieved in only 34% of those with albuminuria.

Bottom Line: Of participants with diabetes, 42% (56/132) had albuminuria compared to 26% (7/27) among those with impaired fasting glucose and 10% (30/303) among those with normal glucose tolerance.Only 5.3% of those with albuminuria were aware of any degree of renal disease.The independent association between BMI and albuminuria has not been previously reported among indigenous populations.

View Article: PubMed Central - HTML - PubMed

Affiliation: Section of Nephrology, Department of Internal Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba R3A 1R9, Canada. jzacharias@exchange.hsc.mb.ca

ABSTRACT

Background: Both diabetic and non-diabetic end stage renal disease (ESRD) are more common among Canadian First Nations people than among the general Canadian population. The purpose of this research was to determine the prevalence of and risk factors for albuminuria in a Canadian First Nation population at high risk for ESRD and dialysis.

Methods: Data from a community-based screening study of 483 residents of a Plains Ojibway First Nation in Manitoba was used. Participants provided random urine samples. Proteinuria was defined as any dipstick positive for protein (≥1 g/L) or those with ACR in the macroalbuminuric range (≥30 mg/mmol) on at least one sample. Microalbuminuria was defined as ACR ≥2 mg/mmol for males and ≥2.8 mg/mmol for females. Other measures included fasting glucose, haemoglobin A1c, triglycerides, cholesterol, blood pressure, height, weight and waist and hip circumferences.

Results: Twenty percent of study participants had albuminuria, (5% proteinuria and 15% microalbuminuria). Of participants with diabetes, 42% (56/132) had albuminuria compared to 26% (7/27) among those with impaired fasting glucose and 10% (30/303) among those with normal glucose tolerance. Only 5.3% of those with albuminuria were aware of any degree of renal disease. In a multivariate logistic regression, independent associations with albuminuria were male gender [p = 0.002], increasing fasting glucose [p <0.0001], years diagnosed with diabetes [p = 0.03], increasing systolic blood pressure [p = 0.009], and increasing body mass index (BMI) [p = 0.04].

Conclusions: The independent association between BMI and albuminuria has not been previously reported among indigenous populations. There is a high prevalence of albuminuria in this Canadian First Nation population; the high proportion of patients with diabetes and undiagnosed kidney disease demonstrates the need for screening, education and intervention to halt the progression and development of albuminuria and ultimately ESRD and CVD.

Show MeSH
Related in: MedlinePlus