Prevalence of hematuria among Zuni Indians with and without diabetes: The Zuni kidney Project.
BACKGROUND
There is an epidemic of kidney disease among the Zuni Indians. In contrast to other American Indian tribes, the epidemic among the Zuni Indians is attributable to diabetic and nondiabetic renal disease.


METHODS
The Zuni Kidney Project, established to reduce the burden of renal disease, conducted a population-based cross-sectional survey of Zuni Indians aged 5 years or older to precisely estimate the prevalence of hematuria. The survey used neighborhood household clusters as the sampling frame to maximize ascertainment and minimize bias. During the survey, we administered a questionnaire; collected blood and urine samples; and measured blood pressure, height, and weight.


RESULTS
Age and sex distributions in our sample (n = 1,469) were similar to those of the eligible Zuni population (n = 9,228). Prevalences of hematuria, defined as dipstick of trace or greater and 50 red blood cells/microL or greater, age- and sex-adjusted to the Zuni population aged 5 years or older, were 33.2% (95% confidence interval [CI], 30.7 to 35.6) and 17.8% (95% CI, 15.8 to 19.8), respectively. Hematuria of trace or greater was more common among females (40.6%; 95% CI, 37.0 to 44.1) than males (25.1%; 95% CI, 21.8 to 28.4). Hematuria of trace or greater was common among Zuni Indians without diabetes (females, 39.7%; 95% CI, 35.7 to 43.8; males, 22.7%; 95% CI, 19.4 to 26.1) and with diabetes (females, 47.5%; 95% CI, 39.8 to 55.2; males, 45.8%; 95% CI, 34.3 to 57.3). Diabetes and alcohol use for greater than 10 years were associated with hematuria among males, but not females.


CONCLUSIONS
The prevalence of hematuria is high among Zuni Indians with and without diabetes. These findings are consistent with the hypothesis that nondiabetic kidney disease is common among Zuni Indians with and without diabetes.
Tentori
Francesca
F
Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131-5241, USA.
Stidley
Christine A
CA
Scavini
Marina
M
Shah
Vallabh O
VO
Narva
Andrew S
AS
Paine
Susan
S
Bobelu
Arlene
A
Welty
Thomas K
TK
Maccluer
Jean W
JW
Zager
Philip G
PG
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000208:ethnology*; D003928:Diabetic Nephropathies / Q000208:ethnology*; D005006:Ethnicity; D005260:Female; D006417:Hematuria / Q000208:ethnology*; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007198:Indians, North American; D008297:Male; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D015995:Prevalence