Paul Komenda1, Barry Lavallee2, Thomas W Ferguson3, Navdeep Tangri3, Caroline Chartrand4, Lorraine McLeod4, Audrey Gordon5, Allison Dart6, Claudio Rigatto3. 1. Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. Electronic address: pkomenda@sbgh.mb.ca. 2. Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada; Diabetes Integration Project, Winnipeg, Manitoba, Canada. Electronic address: barry.lavallee@med.umanitoba.ca. 3. Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada. 4. Diabetes Integration Project, Winnipeg, Manitoba, Canada. 5. Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada. 6. Department of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada.
Abstract
BACKGROUND: Indigenous Canadians have high rates of risk factors for chronic kidney disease (CKD), in particular diabetes. Furthermore, they have increased rates of complications associated with CKD, such as kidney failure and vascular disease. Our objective was to describe the prevalence of CKD in this population. STUDY DESIGN: Cross-sectional cohort. SETTING & PARTICIPANTS: Indigenous (First Nations) Canadians 18 years or older screened as part of the First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis (FINISHED) project, an initiative completed in 2015 that accomplished community-wide screening in 11 rural communities in Manitoba, Canada. PREDICTORS: Indigenous ethnicity and geographic location (communities accessible by road compared with those accessible only by air). OUTCOME: Prevalence of CKD, presumed based on a single ascertainment of urine albumin-creatinine ratio (UACR) ≥ 30mg/g and/or estimated glomerular filtration rate (eGFR)<60mL/min/1.73m(2). MEASUREMENTS: Kidney function measured by eGFR (CKD-EPI creatinine equation) and UACR. RESULTS: 1,346 adults were screened; 25.5% had CKD, defined as UACR≥30mg/g or eGFR<60mL/min/1.73m(2). Communities accessible by road had a lower prevalence of CKD (17.6%) than more remote communities accessible only by air (34.4%). Of those screened, 3.3% had reduced kidney function (defined as eGFR<60mL/min/1.73m(2)). Severely increased albuminuria was present in 5.0% of those screened. LIMITATIONS: Presumption of chronicity based on a single ascertainment. There is a possibility of sampling bias, the net direction of which is uncertain. CONCLUSIONS: We found a 2-fold higher prevalence of CKD in indigenous Canadians in comparison to the general population and a prevalence of severely increased albuminuria that was 5-fold higher. This is comparable to patients with diabetes and/or hypertension. Public health strategies to screen, triage, and treat all Canadian indigenous peoples with CKD should be considered.
BACKGROUND: Indigenous Canadians have high rates of risk factors for chronic kidney disease (CKD), in particular diabetes. Furthermore, they have increased rates of complications associated with CKD, such as kidney failure and vascular disease. Our objective was to describe the prevalence of CKD in this population. STUDY DESIGN: Cross-sectional cohort. SETTING & PARTICIPANTS: Indigenous (First Nations) Canadians 18 years or older screened as part of the First Nations Community Based Screening to Improve Kidney Health and Prevent Dialysis (FINISHED) project, an initiative completed in 2015 that accomplished community-wide screening in 11 rural communities in Manitoba, Canada. PREDICTORS: Indigenous ethnicity and geographic location (communities accessible by road compared with those accessible only by air). OUTCOME: Prevalence of CKD, presumed based on a single ascertainment of urine albumin-creatinine ratio (UACR) ≥ 30mg/g and/or estimated glomerular filtration rate (eGFR)<60mL/min/1.73m(2). MEASUREMENTS: Kidney function measured by eGFR (CKD-EPI creatinine equation) and UACR. RESULTS: 1,346 adults were screened; 25.5% had CKD, defined as UACR≥30mg/g or eGFR<60mL/min/1.73m(2). Communities accessible by road had a lower prevalence of CKD (17.6%) than more remote communities accessible only by air (34.4%). Of those screened, 3.3% had reduced kidney function (defined as eGFR<60mL/min/1.73m(2)). Severely increased albuminuria was present in 5.0% of those screened. LIMITATIONS: Presumption of chronicity based on a single ascertainment. There is a possibility of sampling bias, the net direction of which is uncertain. CONCLUSIONS: We found a 2-fold higher prevalence of CKD in indigenous Canadians in comparison to the general population and a prevalence of severely increased albuminuria that was 5-fold higher. This is comparable to patients with diabetes and/or hypertension. Public health strategies to screen, triage, and treat all Canadian indigenous peoples with CKD should be considered.
Authors: Denise Jaworsky; Mona Loutfy; Michelle Lu; Monica Ye; Andreea Bratu; Paul Sereda; Ahmed Bayoumi; Lisa Richardson; Ayelet Kuper; Robert S Hogg Journal: CMAJ Open Date: 2020-10-19
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: Reid H Whitlock; Mariette Chartier; Paul Komenda; Jay Hingwala; Claudio Rigatto; Randy Walld; Allison Dart; Navdeep Tangri Journal: Can J Kidney Health Dis Date: 2017-04-20