Barr ELM

Barzi F

Hughes Wagadagam , Jaquelyne

Jerums G

O'Dea K

Brown A

Ekinci EI

Jones,GRD

Lawton, P

Sinha A

MacIsaac RJ

Cass A

Maple-Brown LJ

2017-05-14

Risk factors for estimated glomerular filtration rate (eGFR) decline beyond albuminuria are not fully understood in Indigenous Australians who have a 6-fold risk of end-stage kidney disease. We assessed associations between cardio-metabolic risk factors and eGFR decline according to baseline albuminuria status to identify potential treatment targets. The eGFR Follow-up study is a longitudinal cohort of 520 Indigenous Australians. Linear mixed regression was used to estimate associations between baseline cardio-metabolic risk factors and annual Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) eGFR change (ml/min/1.73 m2 /year), among those classified with baseline normoalbuminuria (uACR <3 mg/mmol; n = 297), microalbuminuria (uACR 3-30 mg/mmol; n = 114) and macroalbuminuria (uACR ≥30 mg/mmol; n = 109). After a median of 3.0 years of follow-up, progressive declines of the age- and sex-adjusted mean eGFR was 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/1.72 m2 /year). Although a borderline association was observed between greater baseline HbA1c 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 HDL cholesterol showed non-significant trends with greater eGFR decline in the presence of albuminuria. This study demonstrated that in a three year period marked eGFR decline was observed with greater baseline albuminuria. Cardio-metabolic 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 CKD progression in this population.

Menzies School of Health Research, Wellbeing and Preventable Chronic Disease Division, Darwin, Darwin, Australia.. Baker Heart and Diabetes Institute, Clinical and Population Health, Melbourne, Australia..

Menzies School of Health Research, Wellbeing and Preventable Chronic Disease Division, Darwin, Darwin, Australia..

Menzies School of Health Research, Wellbeing and Preventable Chronic Disease Division, Darwin, Darwin, Australia.. Royal Darwin Hospital, Division of Medicine, Darwin, Australia..

Austin Health, Department of Endocrinology, Melbourne, Australia.. Department of Medicine, University of Melbourne, Melbourne, Australia..

Nutrition and Population Health, University of South Australia, Adelaide, Australia..

Aboriginal Health, Sansom Institute Health Research Operations, University of South Australia, Adelaide, Australia.. South Australian Health and Medical Research Institute, Indigenous Health, Adelaide, Australia..

Menzies School of Health Research, Wellbeing and Preventable Chronic Disease Division, Darwin, Darwin, Australia.. Austin Health, Department of Endocrinology, Melbourne, Australia.. Department of Medicine, University of Melbourne, Melbourne, Australia..

St Vincent's Hospital, SydPath, Sydney, Australia.. University of New South Wales, Department of Medicine, Sydney, Australia..

Menzies School of Health Research, Epidemiology and Health Systems, Darwin, Australia..

Cairns Base Hospital, Diabetes and Endocrinology, Cairns, Australia..

Department of Medicine, University of Melbourne, Melbourne, Australia.. St Vincent's Hospital Melbourne, Department of Endocrinology and Diabetes, Melbourne, Australia..

Menzies School of Health Research, Director, Darwin, Australia..

Menzies School of Health Research, Wellbeing and Preventable Chronic Disease Division, Darwin, Darwin, Australia.. Royal Darwin Hospital, Division of Medicine, Darwin, Australia..

Nephrology (Carlton, Vic.) 2017-05-14

0000-0002-1867-4156

https://pubmed.ncbi.nlm.nih.gov/28503768/?otool=iaurydwlib

https://hdl.handle.net/10137/5237

Indigenous

albuminuria

chronic kidney disease (CKD)

diabetes mellitus

haemoglobin A1c

risk factors

The contribution of cardio-metabolic risk factors to estimated glomerular filtration rate (eGFR) decline in Indigenous Australians with and without albuminuria- the eGFR follow-up study.

Journal Article

Publication