Contribution of cardiometabolic risk factors to estimated glomerular filtration rate decline in Indigenous Australians with and without albuminuria - the eGFR Follow-up Study

Elizabeth Lm Barr, Federica Barzi, Jaquelyne T Hughes, George Jerums, Kerin O'Dea, Alex Brown, Elif I Ekinci, Graham Rd Jones, Paul D Lawton, Ashim Sinha, Richard J MacIsaac, Alan Cass, Louise J Maple-Brown

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

AIM: We assessed associations between cardiometabolic risk factors and estimated glomerular filtration rate (eGFR) decline according to baseline albuminuria to identify potential treatment targets in Indigenous Australians.

METHODS: The eGFR Follow-up Study is a longitudinal cohort of 520 Indigenous Australians. Linear regression was used to estimate associations between baseline cardiometabolic risk factors and annual Chronic Kidney Disease Epidemiology Collaboration eGFR change (mL/min per 1.73m2 /year), among those classified with baseline normoalbuminuria (urine albumin-to-creatinine ratio (uACR) <3 mg/mmol; n = 297), microalbuminuria (uACR 3-30 mg/mmol; n = 114) and macroalbuminuria (uACR ≥30 mg/mmol; n = 109).

RESULTS: After a median of 3 years follow-up, progressive declines of the age- and sex-adjusted mean eGFR were observed across albuminuria categories (-2.0 [-2.6 to -1.4], -2.5 [-3.7 to -1.3] and -6.3 [-7.8 to -4.9] mL/min per 1.72m2 /year). Although a borderline association was observed between greater baseline haemoglobin A1c and eGFR decline in those with macroalbuminuria (P = 0.059), relationships were not significant in those with microalbuminuria (P = 0.187) or normoalbuminuria (P = 0.23). Greater baseline blood pressure, C-reactive protein, waist-to-hip ratio and lower high-density lipoprotein cholesterol showed non-significant trends with greater eGFR decline in the presence of albuminuria.

CONCLUSION: Over a 3 year period, marked eGFR decline was observed with greater baseline albuminuria. Cardiometabolic risk factors were not strong predictors for eGFR decline in Indigenous Australians without albuminuria. Longer follow-up may elucidate the role of these predictors and other mechanisms in chronic kidney disease progression in this population.

Original languageEnglish
Pages (from-to)682-689
Number of pages8
JournalNephrology
Volume23
Issue number7
Early online date14 May 2017
DOIs
Publication statusPublished - Jul 2018

Keywords

  • Adult
  • Aged
  • Albuminuria/diagnosis
  • Australia/epidemiology
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Glomerular Filtration Rate
  • Humans
  • Hyperglycemia/ethnology
  • Kidney/physiopathology
  • Longitudinal Studies
  • Male
  • Metabolic Syndrome/diagnosis
  • Middle Aged
  • Oceanic Ancestry Group
  • Prognosis
  • Renal Insufficiency, Chronic/diagnosis
  • Risk Factors
  • Time Factors

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