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Kidney Week

Abstract: PO2326

Impact of Race/Ethnicity on the Current Screening Approach for CKD

Session Information

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 
 CorrectedUncorrectedCorrectedUncorrectedCorrectedUncorrected
Overall0.63 (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 Surinamese0.63 (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)
Ghanaian0.58 (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)