Linking health care administrative data and laboratory data to study differences in progression of diabetic renal disease in first nations people and other saskatchewan residents

Dyck, Roland; Sidhu, Nirmal; Klomp, Helena; Cascagnette, Paul; Teare, Gary

doi:10.1016/s1499-2671(09)33241-4

Cited by 2 publications

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“…Thus in both DRUID and two remote Indigenous studies, the proportion of participants with albuminuria was several-fold higher than the proportion with low eGFR, whereas the converse was seen in AusDiab. That the ratio of albuminuria to low eGFR is greater in Indigenous than non-Indigenous Australians is also consistent with findings of the NEFRON Study (Australian primary care) [ 26 ] and a recent report comparing First Nations People to other residents of Saskatchewan, Canada [ 27 ].…”

Section: Discussionsupporting

confidence: 83%

High rates of albuminuria but not of low eGFR in Urban Indigenous Australians: the DRUID Study

et al. 2011

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BackgroundIndigenous Australians have an incidence of end stage kidney disease 8-10 times higher than non-Indigenous Australians. The majority of research studies concerning Indigenous Australians have been performed in rural or remote regions, whilst the majority of Indigenous Australians actually live in urban settings. We studied prevalence and factors associated with markers of kidney disease in an urban Indigenous Australian cohort, and compared results with those for the general Australian population.Methods860 Indigenous adult participants of the Darwin Region Urban Indigenous Diabetes (DRUID) Study were assessed for albuminuria (urine albumin-creatinine ratio≥2.5 mg/mmol males, ≥3.5 mg/mmol females) and low eGFR (estimated glomular filtration rate < 60 mls/min/1.73 m2). Associations between risk factors and kidney disease markers were explored. Comparison was made with the AusDiab cohort (n = 8,936 aged 25-64 years), representative of the general Australian adult population.ResultsA high prevalence of albuminuria (14.8%) was found in DRUID, whilst prevalence of low eGFR was 2.4%. Older age, higher HbA1c, hypertension, higher C-reactive protein and current smoking were independently associated with albuminuria on multiple regression. Low eGFR was independently associated with older age, hypertension, albuminuria and higher triglycerides. Compared to AusDiab participants, DRUID participants had a 3-fold higher adjusted risk of albuminuria but not of low eGFR.ConclusionsGiven the significant excess of ESKD observed in Indigenous versus non-Indigenous Australians, these findings could suggest either: albuminuria may be a better prognostic marker of kidney disease than low eGFR; that eGFR equations may be inaccurate in the Indigenous population; a less marked differential between Indigenous and non-Indigenous Australians for ESKD rates in urban compared to remote regions; or that differences in the pathophysiology of chronic kidney disease exist between Indigenous and non-Indigenous populations.

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Section: Discussionsupporting

confidence: 83%

High rates of albuminuria but not of low eGFR in Urban Indigenous Australians: the DRUID Study

et al. 2011

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“…Although speculative, the duration of exposure to diabetes and its interaction with other variables (e.g., quality of diabetes management) might be an important determinant in the relative likelihood of developing specific diabetic complications such as diabetic end-stage renal disease. 32 This should also be a priority area for future research.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of diabetes mellitus among First Nations and non-First Nations adults

Dyck¹,

Osgood²,

Lin³

et al. 2010

Canadian Medical Association Journal

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175

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Linking health care administrative data and laboratory data to study differences in progression of diabetic renal disease in first nations people and other saskatchewan residents

Cited by 2 publications

References 0 publications

High rates of albuminuria but not of low eGFR in Urban Indigenous Australians: the DRUID Study

High rates of albuminuria but not of low eGFR in Urban Indigenous Australians: the DRUID Study

Epidemiology of diabetes mellitus among First Nations and non-First Nations adults

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