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Type: Conference paper
Title: Towards an epidemiologic definition of renal disease: Rates and associations of albuminuria in a high-risk Australian Aboriginal community
Author: Hoy, W.
Mathews, J.
Wang, Z.
McCredie, D.
Hayhurst, B.
Pugsley, D.
Norman, R.
McFarlane, R.
Rees, M.
Kile, E.
Walker, K.
Citation: Proceedings of the Satellite symposium of the XIVth International Congress of Nephrology: Renal Disease in Indigenous Populations, as published in Nephrology, 1998 / vol.4, iss.Suppl. 2, pp.S59-S65
Publisher: Wiley-Blackwell
Issue Date: 1998
ISSN: 1320-5358
Conference Name: Satellite symposium of the XIVth International Congress of Nephrology: Renal Disease in Indigenous Populations (30 May 1997 - 01 Jun 1997 : Ulura (Ayers Rock), Northem Territory, Australia)
Statement of
Wendy E Hoy, John D Mathews, Zhiqiang Wang, David A McCredie, Beverly G Hayhurst, David J Pugsley, Robert J Norman, Robert McFarlane, Megan Rees, Emma Kile and Kate Walker
Abstract: An epidemic of renal failure is accompanying the rising rates of hypertension, type 2 diabetes and cardiovascular disease among Aborigines in the Northern Territory of Australia. the rates and associations of the underlying renal disease were studied in a remote Aboriginal community whose renal failure rates are among the highest reported in the world. More than 90% of school‐age children and adults participated in a health screen, in which the urinary albumin/creatinine ratio (ACR) was used as the primary renal disease marker. Albuminuria was evident in early childhood and increased dramatically with age; 26% of adults had microalbuminuria and 24% had overt albuminuria. Most hypertension segregated in persons with albuminuria and all renal failure developed out of a background of overt albuminuria. ACR levels correlated with the presence of scabies at screening, with a history of post‐streptococcal glomerulonephritis, with increasing bodyweight or its surrogates, with increasing blood pressure, glucose, insulin and lipid levels, and with evidence of heavy drinking. ACR also correlated inversely with birthweight. Finally, increasing ACR correlated with an increasing cardiovascular risk factor score. Thus many factors contribute to renal disease in this community; most are the features and consequences of lifestyle change, poverty and disadvantage. Renal disease shares risk factors, including low birthweight, with Syndrome X, which supports the inclusion of renal disease in that syndrome, and explains the excess cardiovascular morbidity in people with chronic renal disease. There is an urgent need for effective programs to modify recognized risk factors, and to identify and treat people with established renal disease to retard the progression of renal insufficiency.
Keywords: Albuminuria; Australian Aborigines; end-stage renal disease; Syndrome X; urinary albumin/ creatinine ratio
Rights: Copyright status unknown
RMID: 0030068829
DOI: 10.1111/j.1440-1797.1998.tb00474.x
Appears in Collections:Obstetrics and Gynaecology publications

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