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Kidney Week

Abstract: PO2330

Ethnic Differences for Incident CKD in Asians

Session Information

Category: CKD (Non-Dialysis)

  • 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Lim, Cynthia Ciwei, Singapore General Hospital, Singapore, Singapore
  • He, Feng, Singapore Eye Research Institute, Singapore, Singapore
  • Li, Jialiang, Singapore Eye Research Institute, Singapore, Singapore
  • Tham, Yih-Chung, Singapore Eye Research Institute, Singapore, Singapore
  • Tan, Chieh-suai, Singapore General Hospital, Singapore, Singapore
  • Cheng, Ching-Yu, Singapore Eye Research Institute, Singapore, Singapore
  • Wong, Tien Yin, Singapore Eye Research Institute, Singapore, Singapore
  • Sabanayagam, Charumathi, Singapore Eye Research Institute, Singapore, Singapore
Background

Chronic kidney disease (CKD) is a growing health burden in Asia but there is sparse data on incident CKD among different ethnic groups. We aimed to describe the incidence and risk factors associated with incident CKD in the major ethnic groups in Asia.

Methods

Prospective cohort study of 5580 general population participants age 40-80 years (2234 Chinese, 1474 Malays and 1872 Indians) in Singapore who completed both baseline and 6-year follow up visits. Incident CKD was defined as an estimated glomerular filtration rate <60 ml/min/1.73 m2 in those free of CKD at baseline.

Results

The 6-year incidence of CKD was highest among Malays (10.0%), followed by Chinese (6.1%) and Indians (5.8%). Logistic regression showed that older age, diabetes, higher systolic blood pressure and lower eGFR were independently associated with incident CKD in all 3 ethnic groups, while hypertension and cardiovascular disease were independently associated with incident CKD only in Malays. The same factors were identified by machine learning approaches gradient boosted machine (GBM) and random forest (RF) to be the most important for incident CKD (Figure 1). Adjustment for clinical and socioeconomic factors reduced the excess risk in Malays by 60% compared to Chinese but only 13% compared to Indians.

Conclusion

Incidence of CKD is high among the main Asian ethnic groups in Singapore, ranging between 6-10% over 6 years. Differences between ethnic groups were partially explained by clinical and socioeconomic factors. These findings may inform policy development and resource allocation to target risks factors to reduce incident CKD.

Figure 1. Variables associated with incident CKD in each ethnic group, analysed by (A) Logistic Regression (LR), (B) Gradient Boosted Machine (GBM) and (C) Random Forest (RF).

Funding

  • Government Support – Non-U.S.