Abstract: PO2326
Impact of Race/Ethnicity on the Current Screening Approach for CKD
Session Information
- Reassessing Race in Predicting Progression
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Huisman, Brechje, AmsterdamUMC, Amsterdam, Netherlands
- Van den born, Bert-jan, AmsterdamUMC, Amsterdam, Netherlands
- van Valkengoed, Irene, AmsterdamUMC, Amsterdam, Netherlands
- Vogt, Liffert, AmsterdamUMC, Amsterdam, Netherlands
Background
KDIGO recommends screening for chronic kidney disease (CKD) with both estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (ACR). Screening is advised for people with diabetes mellitus, hypertension and/or cardiovascular disease (CVD). People of African descent are at increased risk for CKD, while several reports indicate that the screening approach insufficiently capture CKD in this group. eGFR correction for African race/ethnicity may contribute to this discrepancy, but age and socioeconomic status (SES) may be involved. We assessed whether CKD detection is influenced by race/ethnicity correction and we defined how age >50 yr or lower SES influence CKD detection.
Methods
Baseline data of 21,617 participants (mean age 44 yr, 43% male) of Dutch (4,564), South-Asian Surinamese (3,043), African Surinamese (4,151), Ghanaian (2,339), Moroccan (3,614) and Turkish (3,096) ethnicity included in the multi-ethnic HELIUS cohort study (Amsterdam, The Netherlands) were analysed. We defined CKD as eGFR (CKD-EPI formula, <60mL/min/1.73m2) and/or ACR (≥3mg/mmol). Detection rate was characterised by the c-statistic for three screening approaches in each ethnic group; I) the traditional approach (i.e. screening when having diabetes mellitus, hypertension or CVD); II) the traditional approach plus age >50yr; and III) the traditional approach plus low SES (i.e. none or elementary schooling). C-statistic with and without correction for race/ethnicity were compared.
Results
Of participants, 2335 (11%) had CKD. Estimated CKD was slightly more prevalent in participants of African Surinamese (11 vs 13%) and Ghanaian (12 vs 14%) descent, when the correction for race/ethnicity was discontinued. Compared to approach I, approach II and approach III did not have a higher c-statistic, overall and within African origin subgroups. Results with and without ethnicity/race were similar.
Conclusion
Our study shows that discontinuation of the race/ethnicity correction, or addition of age > 50 yr and low SES as criteria for CKD screening have little impact on the detection rate of the currently advised screening approach.
C-statistic (95%-CI) | Approach I | Approach II | Approach III | |||
Corrected | Uncorrected | Corrected | Uncorrected | Corrected | Uncorrected | |
Overall | 0.63 (0.62-0.64) | 0.63 (0.62-0.64) | 0.64 (0.63-0.65) | 0.64 (0.63-0.65) | 0.63 (0.62-0.65) | 0.64 (0.63-0.65) |
African Surinamese | 0.63 (0.60-0.66) | 0.63 (0.61-0.66) | 0.63 (0.61-0.66) | 0.64 (0.61-0.66) | 0.63 (0.60-0.66) | 0.64 (0.61-0.66) |
Ghanaian | 0.58 (0.55-0.62) | 0.59 (0.56-0.63) | 0.60 (0.56-0.64) | 0.59 (0.55-0.62) | 0.59 (0.56-0.63) | 0.59 (0.56-0.63) |