Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/110434
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Type: | Journal article |
Title: | Clinical outcomes associated with albuminuria in Central Australia: a cohort study |
Author: | Ritte, R. Luke, J. Nelson, C. Brown, A. O'Dea, K. Jenkins, A. Best, J. McDermott, R. Daniel, M. Rowley, K. |
Citation: | BMC Nephrology, 2016; 17(1):113-1-113-10 |
Publisher: | BioMed Central |
Issue Date: | 2016 |
ISSN: | 1471-2369 1471-2369 |
Statement of Responsibility: | Rebecca Ritte, Joanne Luke, Craig Nelson, Alex Brown, Kerin O’Dea, Alicia Jenkins, James D. Best, Robyn McDermott, Mark Daniel and Kevin Rowley |
Abstract: | Background: Chronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia. Methods: Cox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants' baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia. Predictors of progression of albuminuria were also examined in the context of the Kidney Health Australia (KHA) Risk Matrix. Results: A baseline ACR level of ≥3.5 mg/mmol was associated with an almost 10-fold increased risk of ESKD (95%CI 2.07-43.8) and a 15-fold risk of dialysis (95%CI 1.89-121). Albuminuria ≥3.5 mg/mmol was also associated with a borderline 63 % increased risk of CVD (95%CI 0.98-2.71). No significant association was observed with mortality from all-causes or chronic disease. Diabetes and a waist-to-hip ratio ≥0.90 independently predicted a two-fold increased risk of a progression to higher ACR levels. Conclusions: A single measure of moderately increased albuminuria was a strong predictor of renal failure in this population. A single spot urine ACR analysis in conjunction with the KHA Risk Matrix may be a useful and efficient strategy to screen for risk of CKD and progression to dialysis in remote communities. A focus on individuals with diabetes and/or central obesity for strategies to avoid increases in albuminuria may also prevent future CKD and CVD complications. |
Keywords: | Aboriginal people; albuminuria; albumin creatinine ratio; risk; cohort study; end stage renal disease; rural and remote health |
Rights: | © 2016 The Author(s). Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
DOI: | 10.1186/s12882-016-0328-1 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/631947 http://purl.org/au-research/grants/nhmrc/508958 http://purl.org/au-research/grants/nhmrc/299852 |
Published version: | http://dx.doi.org/10.1186/s12882-016-0328-1 |
Appears in Collections: | Aurora harvest 3 Medicine publications |
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