Incidence and causes of end-stage renal disease among Aboriginal children and young adults

Abstract

Background: Although Aboriginal adults have a higher risk of end-stage renal disease than non-Aboriginal adults, the incidence and causes of end-stage renal disease among Aboriginal children and young adults are not well described. Methods:We calculated age-and sex-specific incidences of end-stage renal disease among Aboriginal people less than 22 years of age using data from a national organ failure registry. Incidence rate ratios were used to compare rates between Aboriginal and white Canadians. To contrast causes of end-stage renal disease by ethnicity and age, we calculated the odds of congenital diseases, glomerulonephritis and diabetes for Aboriginal people and compared them with those for white people in the following age strata: 0 to less than 22 years, 22 to less than 40 years, 40 to less than 60 years and older than 60 years.Results: Incidence rate ratios of end-stage renal disease for Aboriginal children and young adults (age < 22 yr, v. white people) were 1.82 (95% confidence interval [CI] 1.40-2.38) for boys and 3.24 (95% CI 2.60-4.05) for girls. Compared with white people, congenital diseases were less common among Aboriginal people aged less than 22 years (odds ratio [OR] 0.56, 95% CI 0.36-0.86), and glomerulonephritis was more common (OR 2.18, 95% CI 1.55-3.07). An excess of glomerulonephritis, but not diabetes, was seen among Aboriginal people aged 22 to less than 40 years. The converse was true (higher risk of diabetes, lower risk of glomerulonephritis) among Aboriginal people aged 40 years and older. Interpretation:The incidence of end-stage renal disease is higher among Aboriginal children and young adults than among white children and young adults. This higher incidence may be driven by an increased risk of glomerulonephritis in this population. AbstractResearch CMAJ, October 2, 2012, 184 (14) E759

Chronic Kidney Disease in Libya, Cross-sectional Single Center Study

“…While El Salvador study by, Orantes et al reported family history of CKD was positive in 21.6% of the study population [17]. In this series GN as a cause of CKD reported in 18% of patients, while Samuel reported GN Aboriginal children and young adults have increased risk of ESRD mostly due to GN in people ≤ 40 years of age [18]. Samuel et al report agrees with the incidence reported with our results.…”

Association between First Nations ethnicity and progression to kidney failure by presence and severity of albuminuria

“…4,5,23,24 Similar to Dyck and colleagues, we report an age-and sex-adjusted rate of kidney failure that is 3-fold higher for First Nations than for non-First Nations people. 24 Previous studies, however, have not included an assessment of albuminuria or potential modifying effects of albuminuria on risk of progression of kidney disease in this population.…”

Earlier Onset of Complications in Youth With Type 2 Diabetes

“…In fact, 9 of 10 children from this population with macroalbuminuria were shown to have either glomerulosclerosis or immunemediated disease on kidney biopsy (26). Recent national data support this finding, which showed that glomerulonephritis was the most common cause of end-stage renal disease in aboriginal children and adults ,40 years old, whereas diabetes started to predominate only after 40 years of age (27). Because the majority of youth with type 2 diabetes in Manitoba are of self-declared aboriginal heritage (5), the high background rate of immunemediated disease can be hypothesized to play an important role in the higher risk of chronic kidney disease in this population, likely potentiated by diabetes.…”