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BMC Public Health. 2012; 12: 290.
Published online Apr 20, 2012. doi:  10.1186/1471-2458-12-290
PMCID: PMC3403871
Prevalence, risk factors and awareness of albuminuria on a Canadian First Nation: A community-based screening study
James Michael Zacharias,corresponding author1 T Kue Young,2 Natalie D Riediger,3 Joanne Roulette,4 and Sharon G Brucecorresponding author3
1Section of Nephrology, Department of Internal Medicine, Health Sciences Centre, University of Manitoba, Room GE644, 820 Sherbrook St, Winnipeg, Manitoba, R3A 1R9, Canada
2Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, Ontario, M5T 3M7, Canada
3Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, Manitoba, R3E 0W3, Canada
4Sandy Bay Ojibway First Nation, Sandy Bay Health Centre, Box 110, Marius, Manitoba, R0H 0T0, Canada
corresponding authorCorresponding author.
James Michael Zacharias: jzacharias/at/exchange.hsc.mb.ca; T Kue Young: kue.young/at/utoronto.ca; Natalie D Riediger: umriedin/at/cc.umanitoba.ca; Joanne Roulette: jroulette_sbhd/at/hotmail.com; Sharon G Bruce: brucesg/at/cc.umanitoba.ca
Received August 12, 2011; Accepted April 20, 2012.
Abstract
Background
Both diabetic and non-diabetic end stage renal disease (ESRD) are more common among Canadian First Nations people than among the general Canadian population. The purpose of this research was to determine the prevalence of and risk factors for albuminuria in a Canadian First Nation population at high risk for ESRD and dialysis.
Methods
Data from a community-based screening study of 483 residents of a Plains Ojibway First Nation in Manitoba was used. Participants provided random urine samples. Proteinuria was defined as any dipstick positive for protein (≥1 g/L) or those with ACR in the macroalbuminuric range (≥30 mg/mmol) on at least one sample. Microalbuminuria was defined as ACR ≥2 mg/mmol for males and ≥2.8 mg/mmol for females. Other measures included fasting glucose, haemoglobin A1c, triglycerides, cholesterol, blood pressure, height, weight and waist and hip circumferences.
Results
Twenty percent of study participants had albuminuria, (5% proteinuria and 15% microalbuminuria). Of participants with diabetes, 42% (56/132) had albuminuria compared to 26% (7/27) among those with impaired fasting glucose and 10% (30/303) among those with normal glucose tolerance. Only 5.3% of those with albuminuria were aware of any degree of renal disease. In a multivariate logistic regression, independent associations with albuminuria were male gender [p = 0.002], increasing fasting glucose [p <0.0001], years diagnosed with diabetes [p = 0.03], increasing systolic blood pressure [p = 0.009], and increasing body mass index (BMI) [p = 0.04].
Conclusions
The independent association between BMI and albuminuria has not been previously reported among indigenous populations. There is a high prevalence of albuminuria in this Canadian First Nation population; the high proportion of patients with diabetes and undiagnosed kidney disease demonstrates the need for screening, education and intervention to halt the progression and development of albuminuria and ultimately ESRD and CVD.
Keywords: Canada, First Nation, Albuminuria, End-stage renal disease, Kidney, Diabetes
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