Abstract: FR-PO407

Tracking of Microalbuminuria and A1c in a High-Risk Zuni Population

Session Information

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 1Time 1 (Yr 2000)Time 2 (Yr 2007)Time 3 (Yr 2014) 
A1C6.1 (1.4)6.1 (1.4)7.0 (2.0)<0.001
UACR58 (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