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The predictive value of albuminuria for renal and nonrenal natural deaths over 14 years follow-up in a remote aboriginal community.

Wang Z, Hoy WE - Clin Kidney J (2012)

Bottom Line: Australian aboriginal people living in remote regions have extraordinary higher rates of mortality compared with other Australian ethnicities.Higher baseline ACR predicted all categories of natural death, with no apparent lower threshold for effect.Albuminuria was still a remarkable predictor for all-cause natural death over an average of 14 years follow-up interval in this aboriginal community.

View Article: PubMed Central - PubMed

Affiliation: Center for Chronic Disease, School of Medicine , The University of Queensland , Australia.

ABSTRACT

Background: Australian aboriginal people living in remote regions have extraordinary higher rates of mortality compared with other Australian ethnicities. Albuminuria marks the underlying renal disease. This study assessed the predictive value of albuminuria for nonrenal and renal deaths in a remote Australian aboriginal community over a follow-up period of >14 years.

Methods: From 1992 to 1997, 85% of community members participated in a health screen, which included measurement of urine albumin/creatinine (ACR) levels. Deaths and dialysis initiations were recorded until 30 November 2010. The rates of natural nonrenal and renal deaths were assessed over a mean of 14 years in the 956 participants aged 18 years and over at baseline, and mortality associated with baseline levels of albuminuria (ACR ≥ 2.7 mg/mmol) was estimated.

Results: There were 203 natural deaths; 70 were renal deaths and 133 were nonrenal deaths, including 60 cardiovascular disease (CVD) deaths. Higher baseline ACR predicted all categories of natural death, with no apparent lower threshold for effect. Baseline ACR ≥ 2.7 mg/mmol predicted a 3.3-fold increase in all natural deaths, a 2-fold increase in nonrenal deaths and a 1.7-fold increase in CVD deaths, after adjustment for other factors. Eighty-nine percent (62 out of 70) of renal deaths occurred in those with ACR ≥ 34 at baseline, with a 24-fold increase in risk. Albuminuria (ACR ≥ 2.7 mg/mmol) contributed to 66% of risk for all natural deaths over the interval.

Conclusions: Albuminuria was still a remarkable predictor for all-cause natural death over an average of 14 years follow-up interval in this aboriginal community.

No MeSH data available.


Related in: MedlinePlus

(A) Survival of all natural deaths by baseline ACR quartiles. (B) Survival of renal death by baseline ACR quartiles. (C) Survival of nonrenal death by baseline ACR quartiles.
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SFS125F1: (A) Survival of all natural deaths by baseline ACR quartiles. (B) Survival of renal death by baseline ACR quartiles. (C) Survival of nonrenal death by baseline ACR quartiles.

Mentions: Table 3 shows the numbers and rates of natural death by quartile of baseline ACR level. The incidence of all natural deaths, nonrenal and CVD deaths rose significantly with increasing ACR quartiles. However, all renal deaths were confined to people in Quartiles 3 and 4 of baseline ACR levels, i.e. ACR ≥ 2.7 mg/mmol. Figure 1A–C shows the Kaplan–Meier survival curves for all natural deaths, renal and nonrenal deaths by baseline ACR quartiles. After 14 years, only 51.4% of people in the highest baseline ACR quartile had avoided all natural deaths: 70.3% had avoided renal deaths and 73.1% had avoided nonrenal deaths. The survival curve of renal death for people within the category of the highest ACR quartile was significantly different from people in lower ACR quartile, as was for nonrenal death.Table 3.


The predictive value of albuminuria for renal and nonrenal natural deaths over 14 years follow-up in a remote aboriginal community.

Wang Z, Hoy WE - Clin Kidney J (2012)

(A) Survival of all natural deaths by baseline ACR quartiles. (B) Survival of renal death by baseline ACR quartiles. (C) Survival of nonrenal death by baseline ACR quartiles.
© Copyright Policy - creative-commons
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400551&req=5

SFS125F1: (A) Survival of all natural deaths by baseline ACR quartiles. (B) Survival of renal death by baseline ACR quartiles. (C) Survival of nonrenal death by baseline ACR quartiles.
Mentions: Table 3 shows the numbers and rates of natural death by quartile of baseline ACR level. The incidence of all natural deaths, nonrenal and CVD deaths rose significantly with increasing ACR quartiles. However, all renal deaths were confined to people in Quartiles 3 and 4 of baseline ACR levels, i.e. ACR ≥ 2.7 mg/mmol. Figure 1A–C shows the Kaplan–Meier survival curves for all natural deaths, renal and nonrenal deaths by baseline ACR quartiles. After 14 years, only 51.4% of people in the highest baseline ACR quartile had avoided all natural deaths: 70.3% had avoided renal deaths and 73.1% had avoided nonrenal deaths. The survival curve of renal death for people within the category of the highest ACR quartile was significantly different from people in lower ACR quartile, as was for nonrenal death.Table 3.

Bottom Line: Australian aboriginal people living in remote regions have extraordinary higher rates of mortality compared with other Australian ethnicities.Higher baseline ACR predicted all categories of natural death, with no apparent lower threshold for effect.Albuminuria was still a remarkable predictor for all-cause natural death over an average of 14 years follow-up interval in this aboriginal community.

View Article: PubMed Central - PubMed

Affiliation: Center for Chronic Disease, School of Medicine , The University of Queensland , Australia.

ABSTRACT

Background: Australian aboriginal people living in remote regions have extraordinary higher rates of mortality compared with other Australian ethnicities. Albuminuria marks the underlying renal disease. This study assessed the predictive value of albuminuria for nonrenal and renal deaths in a remote Australian aboriginal community over a follow-up period of >14 years.

Methods: From 1992 to 1997, 85% of community members participated in a health screen, which included measurement of urine albumin/creatinine (ACR) levels. Deaths and dialysis initiations were recorded until 30 November 2010. The rates of natural nonrenal and renal deaths were assessed over a mean of 14 years in the 956 participants aged 18 years and over at baseline, and mortality associated with baseline levels of albuminuria (ACR ≥ 2.7 mg/mmol) was estimated.

Results: There were 203 natural deaths; 70 were renal deaths and 133 were nonrenal deaths, including 60 cardiovascular disease (CVD) deaths. Higher baseline ACR predicted all categories of natural death, with no apparent lower threshold for effect. Baseline ACR ≥ 2.7 mg/mmol predicted a 3.3-fold increase in all natural deaths, a 2-fold increase in nonrenal deaths and a 1.7-fold increase in CVD deaths, after adjustment for other factors. Eighty-nine percent (62 out of 70) of renal deaths occurred in those with ACR ≥ 34 at baseline, with a 24-fold increase in risk. Albuminuria (ACR ≥ 2.7 mg/mmol) contributed to 66% of risk for all natural deaths over the interval.

Conclusions: Albuminuria was still a remarkable predictor for all-cause natural death over an average of 14 years follow-up interval in this aboriginal community.

No MeSH data available.


Related in: MedlinePlus