BACKGROUND: Despite a low prevalence of chronic kidney disease (estimated glomerular filtration rate [GFR]<60 mL/min per 1.73 m2), First Nations people have high rates of kidney failure requiring chronic dialysis or kidney transplantation. We sought to examine whether the presence and severity of albuminuria contributes to the progression of chronic kidney disease to kidney failure among First Nations people. METHODS: We identified all adult residents of Alberta (age≥18 yr) for whom an outpatient serum creatinine measurement was available from May 1, 2002, to Mar. 31, 2008. We determined albuminuria using urine dipsticks and categorized results as normal (i.e., no albuminuria), mild, heavy or unmeasured. Our primary outcome was progression to kidney failure (defined as the need for chronic dialysis or kidney transplantation, or a sustained doubling of serum creatinine levels). We calculated rates of progression to kidney failure by First Nations status, by estimated GFR and by albuminuria category. We determined the relative hazard of progression to kidney failure for First Nations compared with non-First Nations participants by level of albuminuria and estimated GFR. RESULTS: Of the 1 816 824 participants we identified, 48 669 (2.7%) were First Nations. First Nations people were less likely to have normal albuminuria compared with non-First Nations people (38.7% v. 56.4%). Rates of progression to kidney failure were consistently 2- to 3-fold higher among First Nations people than among non-First Nations people, across all levels of albuminuria and estimated GFRs. Compared with non-First Nations people, First Nations people with an estimated GFR of 15.0-29.9 mL/min per 1.73 m2 had the highest risk of progression to kidney failure, with similar hazard ratios for those with normal and heavy albuminuria. INTERPRETATION: Albuminuria confers a similar risk of progression to kidney failure for First Nations and non-First Nations people.
BACKGROUND: Despite a low prevalence of chronic kidney disease (estimated glomerular filtration rate [GFR]<60 mL/min per 1.73 m2), First Nations people have high rates of kidney failure requiring chronic dialysis or kidney transplantation. We sought to examine whether the presence and severity of albuminuria contributes to the progression of chronic kidney disease to kidney failure among First Nations people. METHODS: We identified all adult residents of Alberta (age≥18 yr) for whom an outpatient serum creatinine measurement was available from May 1, 2002, to Mar. 31, 2008. We determined albuminuria using urine dipsticks and categorized results as normal (i.e., no albuminuria), mild, heavy or unmeasured. Our primary outcome was progression to kidney failure (defined as the need for chronic dialysis or kidney transplantation, or a sustained doubling of serum creatinine levels). We calculated rates of progression to kidney failure by First Nations status, by estimated GFR and by albuminuria category. We determined the relative hazard of progression to kidney failure for First Nations compared with non-First Nations participants by level of albuminuria and estimated GFR. RESULTS: Of the 1 816 824 participants we identified, 48 669 (2.7%) were First Nations. First Nations people were less likely to have normal albuminuria compared with non-First Nations people (38.7% v. 56.4%). Rates of progression to kidney failure were consistently 2- to 3-fold higher among First Nations people than among non-First Nations people, across all levels of albuminuria and estimated GFRs. Compared with non-First Nations people, First Nations people with an estimated GFR of 15.0-29.9 mL/min per 1.73 m2 had the highest risk of progression to kidney failure, with similar hazard ratios for those with normal and heavy albuminuria. INTERPRETATION:Albuminuria confers a similar risk of progression to kidney failure for First Nations and non-First Nations people.
Authors: Song Gao; Braden J Manns; Bruce F Culleton; Marcello Tonelli; Hude Quan; Lynden Crowshoe; William A Ghali; Lawrence W Svenson; Brenda R Hemmelgarn Journal: J Am Soc Nephrol Date: 2007-10-17 Impact factor: 10.121
Authors: William McClellan; David G Warnock; Leslie McClure; Ruth C Campbell; Britt B Newsome; Virginia Howard; Mary Cushman; George Howard Journal: J Am Soc Nephrol Date: 2006-04-26 Impact factor: 10.121
Authors: Hude Quan; Vijaya Sundararajan; Patricia Halfon; Andrew Fong; Bernard Burnand; Jean-Christophe Luthi; L Duncan Saunders; Cynthia A Beck; Thomas E Feasby; William A Ghali Journal: Med Care Date: 2005-11 Impact factor: 2.983
Authors: Christopher Bonneau; Nadine R. Caron; Mohamad A. Hussain; Ahmed Kayssi; Subodh Verma; Mohammed Al-Omran Journal: Can J Surg Date: 2018-10-01 Impact factor: 2.089
Authors: Jade S Hayward; Eric McArthur; Danielle M Nash; Jessica M Sontrop; Storm J Russell; Saba Khan; Jennifer D Walker; Gihad E Nesrallah; Manish M Sood; Amit X Garg Journal: Can J Kidney Health Dis Date: 2017-04-11
Authors: Hilda O Hounkpatin; Simon D S Fraser; Rory Honney; Gavin Dreyer; Alison Brettle; Paul J Roderick Journal: BMC Nephrol Date: 2020-06-09 Impact factor: 2.388