Asian Americans & chronic kidney disease in a nationally representative cohort

Abstract

BackgroundThere is a paucity of specific data on early stages of chronic kidney disease (CKD) among Asian Americans (AAs). The objective of this study was to examine the independent association of Asian race/ethnicity and socio-demographic and co-morbidity factors with markers of early kidney damage, ascertained by ACR levels, as well as kidney dysfunction, ascertained by eGFR levels in a large cross-sectional sample of AAs enrolled in the National Health and Nutrition Examination Survey (NHANES).MethodsSecondary data analyses of the NHANES 2011–2014 data of a nationally representative sample of 5907 participants 18 years and older, US citizens, and of Asian and White race. NHANES data included race (Asian vs. White), as well as other socio-demographic information and comorbidities. Urine albumin-to-creatinine ratio (ACR) categories and estimated glomerular filtration rate (eGFR) were used as indicators for CKD. Descriptive analyses using frequencies, means (standard deviations), and chi-square tests was first conducted, then multivariable logistic regression serial adjustment models were used to examine the associations between race/ethnicity, other socio-demographic factors (age, sex, education), and co-morbidities (obesity, diabetes, hypertension) with elevated ACR levels (A2 & A3 – CKD Stages 3 and 4–5, respectively) as well as reduced eGFR (G3a-G5 and G3b –G5 - CKD Stage 3–5).ResultsAAs were more likely than White participants to have ACR levels > 300 mg/g (A3) (adjusted OR (aOR) (95% CI) 2.77 (1.55, 4.97), p = 0.001). In contrast, adjusted analyses demonstrated that AAs were less likely to have eGFR levels < 60 ml/min/1.73 m2 (G3a-G5) (aOR (95% CI) 0.50 (0.35, 0.72), p < .001).ConclusionsThis is one of the first large U.S. population-based studies of AAs that has shown a comparatively higher risk of elevated ACR > 300 mg/g levels (A3) but lower risk of having eGFR levels < 60 ml/min/1.732 m2 (G3a-G5). The findings support the need to address the gaps in knowledge regarding disparities in risk of early stage CKD among AAs.Electronic supplementary materialThe online version of this article (10.1186/s12882-018-1145-5) contains supplementary material, which is available to authorized users.

<p>Calpain-10 drives podocyte apoptosis and renal injury in diabetic nephropathy</p>

“…Previous studies showed that high lipotoxicity was engaged in the occurrence and development of diabetic nephropathy 21,34–37. Other researches confirmed the significant calcium overload in diabetic nephropathy 38–41. Moreover, calcium overload and lipid metabolites of PA provoked and upregulated calpain 10 which played an essential role in cell apoptosis 27,42.…”

“…Calpain 10 regulates calcium ion efflux into the cytoplasm from mitochondria and endoplasmic reticulum, and triggers the apoptotic pathway 38. Studies show that Calpain 10-induced apoptosis in the cells of the superior renal duct aids in the development of DN.…”

Optimal blood pressure for the prevention of hypertensive nephropathy in nondiabetic hypertensive patients in Taiwan

“…However, studies conducted on Asian and Caucasian populations have shown comparable odds ratios for eGFR < 45 mL/min/1.73 m 2 at 3.19 (1.99–5.1) for DM and 3.31 (2–5.48) for hypertension. Both variables were also significant risk factors for the decrease in eGFR to < 60 mL/min/1.73 m 2 25 . Since we only assessed the effects of BP targets on nondiabetic hypertensive patients, further large‐scale studies of both diabetic and nondiabetic hypertensive patients with different ethnic backgrounds must be conducted to validate these findings.…”

Quality of life and cognitive assessment in healthy older Asian people with early and moderate chronic kidney disease: The NAHSIT 2013–2016 and validation study

“…According to eGFR, CKD is divided into six categories by the international guideline group Kidney Disease Improving Global Outcomes (KDIGO) [11]: early CKD of stage 1 (eGFR of > 90 mL/min/1.73 m 2 ), stage 2 (eGFR of 60-89 mL/min/ 1.73 m 2 ), stages 3a (eGFR of 45-59 mL/min/1.73 m 2 ), and 3b (eGFR of 30-44 mL/min/1.73 m 2 ), late CKD stage 4 (eGFR of 15-29 mL/min/1.73 m 2 ), and stage 5 ESRD (eGFR < 15 mL/ min/1.73 m 2 ). In addition, eGFR is modified by age, sex, and ethnic group [12][13][14].…”