Clinical outcomes associated with albuminuria in central Australia: A cohort study

Rebecca Ritte, Joanne Luke, Craig Nelson, Alex Brown, Kerin O'Dea, Alicia Jenkins, James Best, Robyn McDermott, Mark DANIEL, Kevin Rowley

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background
Chronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia.

Methods
Cox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants’ baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia. Predictors of progression of albuminuria were also examined in the context of the Kidney Health Australia (KHA) Risk Matrix.

Results
A baseline ACR level of ≥3.5 mg/mmol was associated with an almost 10-fold increased risk of ESKD (95%CI 2.07-43.8) and a 15-fold risk of dialysis (95%CI 1.89-121). Albuminuria ≥3.5 mg/mmol was also associated with a borderline 63 % increased risk of CVD (95%CI 0.98-2.71). No significant association was observed with mortality from all-causes or chronic disease. Diabetes and a waist-to-hip ratio ≥0.90 independently predicted a two-fold increased risk of a progression to higher ACR levels.

Conclusions
A single measure of moderately increased albuminuria was a strong predictor of renal failure in this population. A single spot urine ACR analysis in conjunction with the KHA Risk Matrix may be a useful and efficient strategy to screen for risk of CKD and progression to dialysis in remote communities. A focus on individuals with diabetes and/or central obesity for strategies to avoid increases in albuminuria may also prevent future CKD and CVD complications
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalBMC Nephrology
Volume17
Issue number1
DOIs
Publication statusPublished - 2016
Externally publishedYes

Fingerprint

Albuminuria
Cohort Studies
Albumins
Creatinine
Chronic Kidney Failure
Dialysis
Cardiovascular Diseases
Kidney
Waist-Hip Ratio
Abdominal Obesity
Mortality
Health
Kidney Diseases
Proportional Hazards Models
Renal Insufficiency
Reading
Chronic Disease
Urine

Cite this

Ritte, R., Luke, J., Nelson, C., Brown, A., O'Dea, K., Jenkins, A., ... Rowley, K. (2016). Clinical outcomes associated with albuminuria in central Australia: A cohort study. BMC Nephrology, 17(1), 1-10. https://doi.org/10.1186/s12882-016-0328-1
Ritte, Rebecca ; Luke, Joanne ; Nelson, Craig ; Brown, Alex ; O'Dea, Kerin ; Jenkins, Alicia ; Best, James ; McDermott, Robyn ; DANIEL, Mark ; Rowley, Kevin. / Clinical outcomes associated with albuminuria in central Australia: A cohort study. In: BMC Nephrology. 2016 ; Vol. 17, No. 1. pp. 1-10.
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title = "Clinical outcomes associated with albuminuria in central Australia: A cohort study",
abstract = "BackgroundChronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia.MethodsCox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants’ baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia. Predictors of progression of albuminuria were also examined in the context of the Kidney Health Australia (KHA) Risk Matrix.ResultsA baseline ACR level of ≥3.5 mg/mmol was associated with an almost 10-fold increased risk of ESKD (95{\%}CI 2.07-43.8) and a 15-fold risk of dialysis (95{\%}CI 1.89-121). Albuminuria ≥3.5 mg/mmol was also associated with a borderline 63 {\%} increased risk of CVD (95{\%}CI 0.98-2.71). No significant association was observed with mortality from all-causes or chronic disease. Diabetes and a waist-to-hip ratio ≥0.90 independently predicted a two-fold increased risk of a progression to higher ACR levels.ConclusionsA single measure of moderately increased albuminuria was a strong predictor of renal failure in this population. A single spot urine ACR analysis in conjunction with the KHA Risk Matrix may be a useful and efficient strategy to screen for risk of CKD and progression to dialysis in remote communities. A focus on individuals with diabetes and/or central obesity for strategies to avoid increases in albuminuria may also prevent future CKD and CVD complications",
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Ritte, R, Luke, J, Nelson, C, Brown, A, O'Dea, K, Jenkins, A, Best, J, McDermott, R, DANIEL, M & Rowley, K 2016, 'Clinical outcomes associated with albuminuria in central Australia: A cohort study', BMC Nephrology, vol. 17, no. 1, pp. 1-10. https://doi.org/10.1186/s12882-016-0328-1

Clinical outcomes associated with albuminuria in central Australia: A cohort study. / Ritte, Rebecca; Luke, Joanne; Nelson, Craig; Brown, Alex; O'Dea, Kerin; Jenkins, Alicia; Best, James; McDermott, Robyn; DANIEL, Mark; Rowley, Kevin.

In: BMC Nephrology, Vol. 17, No. 1, 2016, p. 1-10.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical outcomes associated with albuminuria in central Australia: A cohort study

AU - Ritte, Rebecca

AU - Luke, Joanne

AU - Nelson, Craig

AU - Brown, Alex

AU - O'Dea, Kerin

AU - Jenkins, Alicia

AU - Best, James

AU - McDermott, Robyn

AU - DANIEL, Mark

AU - Rowley, Kevin

PY - 2016

Y1 - 2016

N2 - BackgroundChronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia.MethodsCox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants’ baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia. Predictors of progression of albuminuria were also examined in the context of the Kidney Health Australia (KHA) Risk Matrix.ResultsA baseline ACR level of ≥3.5 mg/mmol was associated with an almost 10-fold increased risk of ESKD (95%CI 2.07-43.8) and a 15-fold risk of dialysis (95%CI 1.89-121). Albuminuria ≥3.5 mg/mmol was also associated with a borderline 63 % increased risk of CVD (95%CI 0.98-2.71). No significant association was observed with mortality from all-causes or chronic disease. Diabetes and a waist-to-hip ratio ≥0.90 independently predicted a two-fold increased risk of a progression to higher ACR levels.ConclusionsA single measure of moderately increased albuminuria was a strong predictor of renal failure in this population. A single spot urine ACR analysis in conjunction with the KHA Risk Matrix may be a useful and efficient strategy to screen for risk of CKD and progression to dialysis in remote communities. A focus on individuals with diabetes and/or central obesity for strategies to avoid increases in albuminuria may also prevent future CKD and CVD complications

AB - BackgroundChronic kidney disease (CKD) and end-stage-kidney disease (ESKD) continue to be under-diagnosed and a major burden for Aboriginal communities in central Australia. The aim of this study was to examine the risk of poor clinical outcomes associated with elevated albumin-to-creatinine ratio (ACR) among Aboriginal people in central Australia.MethodsCox proportional hazards models were used to estimate the risk of end stage kidney disease (ESKD), dialysis, CVD (cardiovascular disease) and mortality associated with participants’ baseline albuminuria reading from a 10-year cohort study of Aboriginal people (n = 623) from three communities in central Australia. Predictors of progression of albuminuria were also examined in the context of the Kidney Health Australia (KHA) Risk Matrix.ResultsA baseline ACR level of ≥3.5 mg/mmol was associated with an almost 10-fold increased risk of ESKD (95%CI 2.07-43.8) and a 15-fold risk of dialysis (95%CI 1.89-121). Albuminuria ≥3.5 mg/mmol was also associated with a borderline 63 % increased risk of CVD (95%CI 0.98-2.71). No significant association was observed with mortality from all-causes or chronic disease. Diabetes and a waist-to-hip ratio ≥0.90 independently predicted a two-fold increased risk of a progression to higher ACR levels.ConclusionsA single measure of moderately increased albuminuria was a strong predictor of renal failure in this population. A single spot urine ACR analysis in conjunction with the KHA Risk Matrix may be a useful and efficient strategy to screen for risk of CKD and progression to dialysis in remote communities. A focus on individuals with diabetes and/or central obesity for strategies to avoid increases in albuminuria may also prevent future CKD and CVD complications

U2 - 10.1186/s12882-016-0328-1

DO - 10.1186/s12882-016-0328-1

M3 - Article

VL - 17

SP - 1

EP - 10

JO - BMC Nephrology

JF - BMC Nephrology

SN - 1471-2369

IS - 1

ER -