Rikki M Tanner1, Mark Woodward2, Carmen Peralta3, David G Warnock4, Orlando Gutiérrez4, Daichi Shimbo5, Holly Kramer6, Ronit Katz7, Paul Muntner8. 1. 1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL. 2. 2. The George Institute for Global Health, Nuffield Department of Population Health, University of Oxford, Oxford, UK ; 3. The George Institute for Global Health, University of Sydney, Sydney, Australia ; 4. Department of Epidemiology, Johns Hopkins University, Baltimore, MD. 3. 5. Department of Medicine, University of California San Francisco, San Francisco, CA. 4. 6. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL. 5. 7. Department of Medicine, Columbia University Medical Center, New York, NY. 6. 9. Department of Medicine, Loyola University Medical Center, Chicago, IL. 7. 9. Kidney Research Institute, University of Washington, Seattle, WA. 8. 1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL ; 6. Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
Abstract
OBJECTIVE: We previously developed an 8-item self-assessment tool to identify individuals with a high probability of having albuminuria. This tool was developed and externally validated among non-Hispanic Whites and non-Hispanic Blacks. We sought to validate it in a multi-ethnic cohort that also included Hispanics and Chinese Americans. DESIGN: This is a cross-sectional study. SETTING: Data were collected using standardized questionnaires and spot urine samples at a baseline examination in 2000-2002. The 8 items in the self-assessment tool include age, race, gender, current cigarette smoking, history of diabetes, hypertension, or stroke, and self-rated health. PARTICIPANTS: Of 6,814 community-dwelling adults aged 45-84 years participating in the Multi-Ethnic Study of Atherosclerosis (MESA), 6,542 were included in the primary analysis. MAIN OUTCOME MEASURES: Albuminuria was defined as urine albumin-to-creatinine ratio ≥ 30 mg/g at baseline. RESULTS: Among non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Chinese Americans, the prevalence of albuminuria was 6.0%, 11.3%, 11.6%, and 10.8%, respectively. The c-statistic for discriminating participants with and without albuminuria was .731 (95% CI: .692, .771), .728 (95% CI: .687, .761), .747 (95% CI: .709, .784), and .761 (95% CI: .699, .814) for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Chinese Americans, respectively. The self-assessment tool over-estimated the probability of albuminuria for non-Hispanic Whites and Blacks, but was well-calibrated for Hispanics and Chinese Americans. CONCLUSIONS: The albuminuria self-assessment tool maintained good test characteristics in this large multi-ethnic cohort, suggesting it may be helpful for increasing awareness of albuminuria in an ethnically diverse population.
OBJECTIVE: We previously developed an 8-item self-assessment tool to identify individuals with a high probability of having albuminuria. This tool was developed and externally validated among non-Hispanic Whites and non-Hispanic Blacks. We sought to validate it in a multi-ethnic cohort that also included Hispanics and Chinese Americans. DESIGN: This is a cross-sectional study. SETTING: Data were collected using standardized questionnaires and spot urine samples at a baseline examination in 2000-2002. The 8 items in the self-assessment tool include age, race, gender, current cigarette smoking, history of diabetes, hypertension, or stroke, and self-rated health. PARTICIPANTS: Of 6,814 community-dwelling adults aged 45-84 years participating in the Multi-Ethnic Study of Atherosclerosis (MESA), 6,542 were included in the primary analysis. MAIN OUTCOME MEASURES: Albuminuria was defined as urine albumin-to-creatinine ratio ≥ 30 mg/g at baseline. RESULTS: Among non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Chinese Americans, the prevalence of albuminuria was 6.0%, 11.3%, 11.6%, and 10.8%, respectively. The c-statistic for discriminating participants with and without albuminuria was .731 (95% CI: .692, .771), .728 (95% CI: .687, .761), .747 (95% CI: .709, .784), and .761 (95% CI: .699, .814) for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, and Chinese Americans, respectively. The self-assessment tool over-estimated the probability of albuminuria for non-Hispanic Whites and Blacks, but was well-calibrated for Hispanics and Chinese Americans. CONCLUSIONS: The albuminuria self-assessment tool maintained good test characteristics in this large multi-ethnic cohort, suggesting it may be helpful for increasing awareness of albuminuria in an ethnically diverse population.
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