Renal function and cardiovascular risk markers in a remote Australian Aboriginal community

Background. Australian Aborigines living in remote areas have exceedingly high rates of renal failure together with increased cardiovascular morbidity and mortality. To examine the basis of this association, we studied markers of renal function and cardiovascular (CV) risk in a coastal Aboriginal co...

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Bibliographic Details
Published in:Nephrology, dialysis, transplantation dialysis, transplantation, 2003-08, Vol.18 (8), p.1555-1561
Main Authors: McDonald, Stephen P., Maguire, Graeme P., Hoy, Wendy E.
Format: Article
Language:English
Subjects:
Adult
Aged
albuminuria
Australian Aborigines
Biological and medical sciences
cardiovascular disease
Cardiovascular Diseases - ethnology
cardiovascular markers
Creatinine - blood
Cross-Sectional Studies
end-stage renal disease
Glomerular Filtration Rate
Glycated Hemoglobin A - analysis
Humans
Incidence
Kidney Failure, Chronic - ethnology
Kidneys
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Northern Territory - epidemiology
Oceanic Ancestry Group
Risk Factors
Urinary system involvement in other diseases. Miscellaneous
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Summary:Background. Australian Aborigines living in remote areas have exceedingly high rates of renal failure together with increased cardiovascular morbidity and mortality. To examine the basis of this association, we studied markers of renal function and cardiovascular (CV) risk in a coastal Aboriginal community in a remote area of the Northern Territory of Australia. End-stage renal disease (ESRD) incidence rates in that community are 15 times the national non-Aboriginal rate and CV mortality rates in the region are increased 5-fold. Methods. A cross-sectional community survey was conducted. Markers of early renal disease examined included urine albumin/creatinine ratio (ACR), serum creatinine concentration and calculated glomerular filtration rate (GFR). CV risk markers included blood pressure as well as measures of glycaemia, diabetes and serum lipids. Results. The study group included 237 people, 58% of the adult population of the community. The crude prevalence of microalbuminuria (urine ACR: 3.4–33.9 g/mol, 30–299 mg/g) was 31% and of overt albuminuria (urine ACR: ≥34 g/mol, ≥300 mg/g), 13%. The prevalence of overt albuminuria increased with age, but the prevalence of microalbuminuria was greatest in the 45–54 year age group. Microalbuminuria was associated with increasing body mass index, whereas overt albuminuria was associated with increasing glycated haemoglobin (HbA1c) and systolic blood pressure and a history of diabetes. The prevalence of elevated serum creatinine concentration (≥120 µmol/l) was 10%. GFR (calculated using the MDRD equation) was
ISSN:0931-0509
1460-2385
1460-2385
DOI:10.1093/ndt/gfg199