Abstract: FR-PO407
Tracking of Microalbuminuria and A1c in a High-Risk Zuni Population
Session Information
- CKD: Risk Factors for Incidence and Progression - I
November 03, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Chronic Kidney Disease (Non-Dialysis)
- 301 CKD: Risk Factors for Incidence and Progression
Authors
- Shah, Vallabh O., University of New Mexico Health Science Center, Albuquerque, New Mexico, United States
- Pankratz, V. Shane, University of New Mexico Health Science Center, Albuquerque, New Mexico, United States
- Nelson, Robert G., National Institutes of Health, Phoenix, Arizona, United States
- Ghahate, Donica M., University of New Mexico Health Science Center, Albuquerque, New Mexico, United States
- Bobelu, Jeanette, University of New Mexico Health Science Center, Albuquerque, New Mexico, United States
Background
The Zuni Indians are disproportionately affected by diabetes and chronic kidney disease, signaling a need for effective community-based prevention efforts. We previously reported on the epidemic of kidney disease and its intermediate phenotypes, and described the heritability of these conditions. Recently, through a Patient Center Outcomes Research Institute (PCORI)-funded study of home-based kidney care (HBKC), we rescreened 314 Zuni participants and examined changes in a constellation of markers of kidney disease and diabetes in a subset of these participants.
Methods
Summaries of the risk factors in the 155 participants (73 [47%] female; mean [SD] age at baseline 33.7 [11.5] years) at three key time points shown in the table 1.
Results
The development of ESRD in 7 individuals in this study set of 155 participants with longitudinal follow-up underscores the high incidence of renal disease in this population. These incident cases of renal disease occurred in 2081.7 person-years of follow-up, leading to an estimated incidence rate of CKD in this population of 3.8 (95% CI: 1.9 – 7.7) events per 1000 person years.
Conclusion
This analysis of a cohort of individuals from the PCORI studied at 3 time points over up to 14.3 years shows significantly increasing UACR and A1C levels, and a high incidence of kidney disease. These findings reinforce the need for interventions to modify risk factors for CKD progression, such as our PCORI-supported pilot HBKC intervention in this high-risk population, particularly amongst young adult Zuni.
| Table 1 | Time 1 (Yr 2000) | Time 2 (Yr 2007) | Time 3 (Yr 2014) | |
| A1C | 6.1 (1.4) | 6.1 (1.4) | 7.0 (2.0) | <0.001 |
| UACR | 58 (156) | 106 (337) | 976 (2679) | <0.001 |
*Mean (SD). Repeated measures analysis of variance models were performed to test for trends in risk factors over time (P<0.05 indicates statistical significance).
Funding
- Other U.S. Government Support