Risk Factors for Proteinuria in a Large, Multiracial, Southeast Asian Population

Ramirez, Sylvia; McClellan, William; Port, Friedrich K.; Hsu, Stephen I‐Hong

doi:10.1097/01.asn.0000018406.20282.c8

Cited by 147 publications

(151 citation statements)

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“…[1][2][3][4][5] In addition to the underlying primary pathological state, several factors, such as lifestyle, socioeconomic status (SES), and occupational exposures, were suggested to modify the progression and outcome of kidney diseases and may be responsible, in part, for the disproportionately high rates of end-stage renal disease in such subgroups as racial/ethnic minorities. [6][7][8][9][10] African Americans were reported to have greater rates of proteinuria. 11 It also is known that racial and ethnic minority status in the United States often is associated with low SES, and these factors may impact on clinical outcomes in a wide variety of diseases, including CVD and CKD.…”

mentioning

confidence: 99%

The Association of Poverty With the Prevalence of Albuminuria: Data From the Third National Health and Nutrition Examination Survey (NHANES III)

Martins

Tareen

Zadshir

et al. 2006

American Journal of Kidney Diseases

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Background-Albuminuria is a major risk factor for the development and progression of chronic kidney disease (CKD) and cardiovascular disease. Socioeconomic factors also have been reported to modify CKD and cardiovascular risk factors and clinical outcomes. The extent to which poverty influences the prevalence of albuminuria, particularly among racial/ethnic minority populations, is not well established. The influence of poverty on the prevalence of albuminuria and the implication of this relationship for the racial and/or ethnic differences in the prevalence of albuminuria were examined.

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mentioning

confidence: 99%

The Association of Poverty With the Prevalence of Albuminuria: Data From the Third National Health and Nutrition Examination Survey (NHANES III)

Martins

Tareen

Zadshir

et al. 2006

American Journal of Kidney Diseases

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“…Systolic BP (SBP) was Ն140 mmHg in 14.6% in this relatively healthy working population. Important predictors for proteinuria that have been identified in this uniquely Asian population include mild elevations in SBP and DBP, both extremes of body mass index, increasing age, and family history of renal disease (26). In addition, racial differences in prevalence of proteinuria were noted.…”

Section: Surveillance and Early Detectionmentioning

confidence: 90%

“…Details of the screening program are described elsewhere (26). Briefly, screening for urinary abnormalities and other risk factors for chronic diseases that could lead to CKD is targeted to four discrete populations, as follows: the working population through worksite screening; the general adult population through community-based screening; the pediatric population through school screening; and a specific occupational group, the taxi driver population of Singapore.…”

Section: Surveillance and Early Detectionmentioning

confidence: 99%

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A Comprehensive Public Health Approach to Address the Burden of Renal Disease in Singapore

Ramirez¹

2003

Journal of the American Society of Nephrology

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Abstract. With the epidemic rise of ESRD in multiple regions of the world, there is an urgent need to implement programs to address this increasing burden of kidney disease. We illustrate a public health approach using the program of the National Kidney Foundation of Singapore that incorporates stepwise primary, secondary, and tertiary strategies for prevention. Components of the program include an aggressive public education program, routine surveillance for kidney disease and associated chronic diseases, the implementation of a disease management program to improve physician practice patterns, and the provision of comprehensive services in the community through a network of Prevention Centers designed to optimize the care of patients at risk for kidney disease. Finally, an equally important aspect is the clinical and epidemiologic research component, because this will provide clear benchmarks to determine the program's effect on ESRD as well as generate information that can be used to identify future directions for this evolving program.The rising annual incidence of ESRD in many countries of the world (1), its profound effect on morbidity and mortality, and the escalating health care costs associated with it have promoted the development of strategies aimed at preventing the development and progression of chronic kidney disease (CKD). These include population-based and high risk screening programs (2,3), the initiation of public education campaigns targeted at improving public awareness of kidney disease and its consequences (4), and the dissemination of evidence-based guidelines for the approach to CKD (5). Current clinical recommendations for several components of kidney disease prevention are based on consensus expert opinion rather than on clinical trial data (5). In addition, many of these programs are in the early stages of implementation and thus, the cumulative effectiveness of these independent interventions remains to be seen. Similarly, in Singapore, a program for the prevention of kidney failure is still in its infancy. Nevertheless, given its integrated public health and community-based approach, with components of screening, early detection, and early intervention, as well as the country's small size and unique logistical and demographic advantages, the NKF Singapore Prevention Program merits consideration.The National Kidney Foundation Singapore (NKFS), the largest charitable organization in the country, is responsible for providing subsidized dialysis care to over 60% of the country's total ESRD population (6). The Prevention Program, components of which were initiated in 1997, has a long-term goal of effecting a plateau in the rising incidence of ESRD in the country based on a framework of the natural history of kidney disease development and progression. It incorporates stepwise primary, secondary, and tertiary prevention approaches to intervene at various stages of kidney disease and associated chronic diseases, including type 2 diabetes mellitus and hypertension (7). This report describes ...

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“…The association of albuminuria with BP was also studied in 189,117 adult participants in a screen- ing program in Singapore (16). BP was measured 2 to 3 times, and the average BP was calculated.…”

Section: Association Of Hypertension With Indicators Of Renal Diseasementioning

confidence: 99%

Hypertension and Renal Dysfunction

Jones¹

2003

Journal of the American Society of Nephrology

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Abstract. The incidence rate of end-stage renal disease has increased in many countries in the past 20 yr, including the United States and Singapore. The increase in ESRD incidence in the United States is primarily attributable to diabetes and to hypertension. In Singapore the major cause of ESRD is diabetes, however the prevalence of hypertension in the Singapore population is rising rapidly, and renal complications of hypertension may become more common in the future. Information on the association of hypertension with renal dysfunction and ESRD in the United States may be useful in predicting future trends in the incidence of ESRD due to hypertension in Singapore. This paper describes published and unpublished data presented at a conference to assist in developing plans for a comprehensive renal disease prevention program in Singapore. It compares recent data on the reported prevalence of hypertension in the United States and Singapore; and presents information on the association of hypertension with serum creatinine, urinary albumin excretion, and ESRD in the United States.The incidence rate of end-stage renal disease has increased in many countries in the past 20 yr, including the United States (1) and Singapore (2). In 1997, Singapore had one of the highest incidence rates of ESRD in the world (158 cases per million), a rate that was comparable to the United States (296 cases per million) and Japan (229 cases per million) (3). In the US population, the increase in ESRD incidence is primarily attributable to diabetes and to hypertension, whereas in Singapore the major cause of ESRD is diabetes.Comparison of trends in prevalence of hypertension in the United States and Singapore can be mutually useful. The association of hypertension with renal dysfunction and ESRD in the United States may be useful to health planners in Singapore in predicting trends in the incidence of ESRD due to hypertension, and in planning a renal disease prevention program. Conversely, the periodic National Health and Nutrition Examination Surveys (NHANES) in the United States have not been designed to provide subgroup analyses for Asian ethnic subgroups, and data on the prevalence of hypertension in Singapore may provide insight into disease patterns among US residents who are of Chinese, Asian Indian, and other Asian ethnic descent. This paper describes published and unpublished data presented at a conference to assist in developing plans for a comprehensive renal disease prevention program in Singapore. It compares the reported prevalence of hypertension in the United States and Singapore, and presents information on the association of hypertension with serum creatinine, urinary albumin excretion, and ESRD in the United States. Materials and MethodsNHANES III is a cross-sectional examination survey of the US civilian noninstitutionalized population that was implemented in two nationally representative phases (phase 1 in 1988 to 1991, and phase 2 in 1992 to 1994) (4). Overall, more than 29,300 persons aged 6 mo and older participate...

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Risk Factors for Proteinuria in a Large, Multiracial, Southeast Asian Population

Cited by 147 publications

References 23 publications

The Association of Poverty With the Prevalence of Albuminuria: Data From the Third National Health and Nutrition Examination Survey (NHANES III)

The Association of Poverty With the Prevalence of Albuminuria: Data From the Third National Health and Nutrition Examination Survey (NHANES III)

A Comprehensive Public Health Approach to Address the Burden of Renal Disease in Singapore

Hypertension and Renal Dysfunction

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