Study protocol - Accurate assessment of kidney function in indigenous Australians: Aims and methods of the eGFR study

Louise J. Maple-Brown, Paul D. Lawton, Jaquelyne T. Hughes, Suresh K. Sharma, Graham Rd Jones, Andrew G. Ellis, Wendy Hoy, Alan Cass, Richard J. MacIsaac, Ashim K. Sinha, Mark Ab Thomas, Leonard S. Piers, Leigh C. Ward, Katrina Drabsch, Sianna Panagiotopoulos, Robyn McDermott, Kevin Warr, Sajiv Cherian, Alex Brown, George Jerums & 1 others Kerin O'Dea

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background. There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design. A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history. Discussion. We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.

LanguageEnglish
Article number80
JournalBMC Public Health
Volume10
DOIs
Publication statusPublished - 11 Mar 2010

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Maple-Brown, L. J., Lawton, P. D., Hughes, J. T., Sharma, S. K., Jones, G. R., Ellis, A. G., ... O'Dea, K. (2010). Study protocol - Accurate assessment of kidney function in indigenous Australians: Aims and methods of the eGFR study. BMC Public Health, 10, [80]. https://doi.org/10.1186/1471-2458-10-80
Maple-Brown, Louise J. ; Lawton, Paul D. ; Hughes, Jaquelyne T. ; Sharma, Suresh K. ; Jones, Graham Rd ; Ellis, Andrew G. ; Hoy, Wendy ; Cass, Alan ; MacIsaac, Richard J. ; Sinha, Ashim K. ; Thomas, Mark Ab ; Piers, Leonard S. ; Ward, Leigh C. ; Drabsch, Katrina ; Panagiotopoulos, Sianna ; McDermott, Robyn ; Warr, Kevin ; Cherian, Sajiv ; Brown, Alex ; Jerums, George ; O'Dea, Kerin. / Study protocol - Accurate assessment of kidney function in indigenous Australians : Aims and methods of the eGFR study. In: BMC Public Health. 2010 ; Vol. 10.
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abstract = "Background. There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design. A cross-sectional study of Indigenous Australian adults (target n = 600, 50{\%} male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history. Discussion. We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.",
author = "Maple-Brown, {Louise J.} and Lawton, {Paul D.} and Hughes, {Jaquelyne T.} and Sharma, {Suresh K.} and Jones, {Graham Rd} and Ellis, {Andrew G.} and Wendy Hoy and Alan Cass and MacIsaac, {Richard J.} and Sinha, {Ashim K.} and Thomas, {Mark Ab} and Piers, {Leonard S.} and Ward, {Leigh C.} and Katrina Drabsch and Sianna Panagiotopoulos and Robyn McDermott and Kevin Warr and Sajiv Cherian and Alex Brown and George Jerums and Kerin O'Dea",
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Maple-Brown, LJ, Lawton, PD, Hughes, JT, Sharma, SK, Jones, GR, Ellis, AG, Hoy, W, Cass, A, MacIsaac, RJ, Sinha, AK, Thomas, MA, Piers, LS, Ward, LC, Drabsch, K, Panagiotopoulos, S, McDermott, R, Warr, K, Cherian, S, Brown, A, Jerums, G & O'Dea, K 2010, 'Study protocol - Accurate assessment of kidney function in indigenous Australians: Aims and methods of the eGFR study', BMC Public Health, vol. 10, 80. https://doi.org/10.1186/1471-2458-10-80

Study protocol - Accurate assessment of kidney function in indigenous Australians : Aims and methods of the eGFR study. / Maple-Brown, Louise J.; Lawton, Paul D.; Hughes, Jaquelyne T.; Sharma, Suresh K.; Jones, Graham Rd; Ellis, Andrew G.; Hoy, Wendy; Cass, Alan; MacIsaac, Richard J.; Sinha, Ashim K.; Thomas, Mark Ab; Piers, Leonard S.; Ward, Leigh C.; Drabsch, Katrina; Panagiotopoulos, Sianna; McDermott, Robyn; Warr, Kevin; Cherian, Sajiv; Brown, Alex; Jerums, George; O'Dea, Kerin.

In: BMC Public Health, Vol. 10, 80, 11.03.2010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Study protocol - Accurate assessment of kidney function in indigenous Australians

T2 - BMC Public Health

AU - Maple-Brown, Louise J.

AU - Lawton, Paul D.

AU - Hughes, Jaquelyne T.

AU - Sharma, Suresh K.

AU - Jones, Graham Rd

AU - Ellis, Andrew G.

AU - Hoy, Wendy

AU - Cass, Alan

AU - MacIsaac, Richard J.

AU - Sinha, Ashim K.

AU - Thomas, Mark Ab

AU - Piers, Leonard S.

AU - Ward, Leigh C.

AU - Drabsch, Katrina

AU - Panagiotopoulos, Sianna

AU - McDermott, Robyn

AU - Warr, Kevin

AU - Cherian, Sajiv

AU - Brown, Alex

AU - Jerums, George

AU - O'Dea, Kerin

PY - 2010/3/11

Y1 - 2010/3/11

N2 - Background. There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design. A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history. Discussion. We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.

AB - Background. There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians. Methods/Design. A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C- derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history. Discussion. We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.

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