Increased prevalence of albuminuria among non-European peoples with type 2 diabetes

• Published in: Nephrology, dialysis, transplantation dialysis, transplantation, 2012-05, Vol.27 (5), p.1840-1846
• Main Authors: KENEALY, Timothy, ELLEY, Carolyn Raina, COLLINS, John F, MOYES, Simon A, METCALF, Patricia A, DRURY, Paul L
• Format: Article
• Language: English
• Subjects: Albuminuria - blood; Albuminuria - epidemiology; Albuminuria - ethnology; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Associated diseases and complications; Biological and medical sciences; Cohort Studies; Creatinine - blood; Cross-Sectional Studies; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - ethnology; Diabetes. Impaired glucose tolerance; Emergency and intensive care: renal failure. Dialysis management; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Far East - ethnology; Female; Humans; Intensive care medicine; Male; Medical sciences; Middle Aged; New Zealand - epidemiology; Pacific Islands - ethnology; Prevalence; Regression Analysis; Retrospective Studies; Risk Factors; Serum Albumin - metabolism
• ISSN: 0931-0509; 1460-2385
• DOI: 10.1093/ndt/gfr540

A high incidence of albuminuria, varying by ethnicity, has been found in a number of populations worldwide. There have been few opportunities to explore the prevalence of albuminuria as a marker of chronic kidney disease while adjusting for other risk factors in the different ethnic groups in New Zealand. We examined the association between albuminuria and ethnicity using cross-sectional data from a large cohort study of type 2 diabetes conducted in New Zealand. The study population was 65 171 adults in primary care with type 2 diabetes, not on renal replacement therapy; median age was 64.7 years, median diabetes duration 5.1 years and 48.5% were non-European. Microalbuminuria or greater was present in 50% of Maori, 49% of Pacific people, 31% of Indo- and East-Asians and 28% of Europeans. Regression analyses were used to examine the association between ethnicity and albuminuria-measured as albumin:creatinine ratio-after controlling for study site and other known risk variables: age, sex, duration of diabetes, smoking status, socioeconomic status, body mass index, systolic and diastolic blood pressure, triglyceride levels, HbA(1C) and being on an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker. After controlling for these risk factors and compared with Europeans, odds ratios for 'advanced' albuminuria (≥100 mg/mmol) were 3.9 (95% confidence interval: 3.2-4.6) in Maori, 4.7 (3.6-6.3) in Pacific people, 2.0 (1.5-2.7) in Indo-Asians and 4.1 (3.2-5.1) in East-Asians. Non-European ethnicities appear to carry significantly higher risks of albuminuria in type 2 diabetes.