Kidney disease among the Zuni Indians: the Zuni Kidney Project.
BACKGROUND
There is an epidemic of kidney disease among the Zuni Indians. In collaboration with health care providers and research institutions, the Zuni Pueblo established the Zuni Kidney Project to reduce the burden of kidney disease.


METHODS
The Zuni Kidney Project conducted a population-based, cross-sectional survey to estimate the prevalence of albuminuria, hematuria, and related risk factors. Neighborhood household clusters served as the sampling frame. Participants completed a questionnaire, donated blood and urine samples, and had blood pressure, height, and weight measured. This survey provided the foundation for ongoing studies to identify genetic and environmental risk factors for disease susceptibility and progression.


RESULTS
Age and gender distributions among survey participants were similar to those in the eligible Zuni population. Prevalence of incipient albuminuria (IA) (0.03< or = urine albumin:creatinine ratio, UACR <0.3) and overt albuminuria (OA) (UACR < 0.3) were higher among diabetics [IA 34.3% (28.3, 40.4%); OA 18.6% (13.7, 23.6%)] than nondiabetics [IA 11.1% (9.3, 12.8%); OA 1.7% (1.0, 2.5%)]. Nondiabetics comprised 58.6% (52.2, 65.0%) and 30.9% (19.9, 41.9%) of participants with IA and OA, respectively. The prevalence of hematuria was higher among diabetics [> or = trace 47.0% (40.7, 53.4); > or =50 red blood cell/microL 25.8% (20.3, 31.4%)] than nondiabetics [> or = trace 31.1% (28.5, 33.7%); > or =50 red blood cell/microL 16.6% (14.5, 18.7%)]. Hypertension was associated with albuminuria among diabetic and nondiabetic participants. Hypercholesterolemia was associated with albuminuria among nondiabetic participants. Diabetes and alcohol use were associated with hematuria.


CONCLUSIONS
The high prevalences of albuminuria among nondiabetics and of hematuria among diabetics and nondiabetics are consistent with high rates of nondiabetic kidney disease among Zuni Indians with and without diabetes.
Scavini
Marina
M
Dialysis Clinic, Inc., Albuquerque, New Mexico, USA.
Shah
Vallabh O
VO
Stidley
Christine A
CA
Tentori
Francesca
F
Paine
Susan S
SS
Harford
Antonia M
AM
Narva
Andrew S
AS
Kessler
David S
DS
Bobelu
Arlene
A
Albert
Carleton P
CP
Bobelu
Jeanette
J
Jamon
Eunice
E
Natachu
Kathy
K
Neha
Donica
D
Welty
Thomas K
TK
MacCluer
Jean W
JW
Zager
Philip G
PG
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006293:Health Promotion; D006417:Hematuria / Q000453:epidemiology; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007198:Indians, North American / Q000706:statistics & numerical data*; D007674:Kidney Diseases / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D012307:Risk Factors