Natural history of chronic kidney disease in Australian Indigenous and non-Indigenous children: a 4-year population-based follow-up study.
OBJECTIVE
To describe the natural history and risk of early chronic kidney disease (CKD) in Indigenous Australian populations.


METHODS
A prospective cohort of 2266 Aboriginal and non-Aboriginal children enrolled from primary schools throughout New South Wales from February 2002 to June 2004 and followed for 4 years.


METHODS
Urinalysis, height, weight, blood pressure, birthweight and sociodemographic status at baseline and 2- and 4-year follow-up; CKD risk factors: haematuria, albuminuria, obesity, and systolic and diastolic hypertension.


RESULTS
2266 children (55% Aboriginal; 51% male; mean age, 8.9 years [SD, 2.0 years]) were enrolled at baseline. 1432 children (63%) were retested at 2-year follow-up, and 1506 children (67%) at 4-year follow-up. Prevalence of baseline CKD risk factors was frequent (2%-7%), but most abnormalities were transient. Besides persistent obesity (5.0%), persistence of CKD risk factors at final follow-up was low: haematuria (1.9%), albuminuria (2.4%), systolic hypertension (1.5%) and diastolic hypertension (0.2%). There was no difference in prevalence of persistent CKD risk factors between Aboriginal and non-Aboriginal children.


CONCLUSIONS
Over 4 years of follow-up, Indigenous Australian children had no increased risk for early evidence of CKD. More than 70% of baseline risk factors were transient, and persistent risk factors were uncommon. Our findings suggest the increased risk for end-stage kidney disease seen in Indigenous adults is not yet manifest in these schoolchildren, and may be potentially preventable.
Haysom
Leigh
L
Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia. LeighH@chw.edu.au
Williams
Rita
R
Hodson
Elisabeth M
EM
Lopez-Vargas
Pamela A
PA
Roy
Leslie P
LP
Lyle
David M
DM
Craig
Jonathan C
JC
D000293:Adolescent; D000419:Albuminuria / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006417:Hematuria / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D007676:Kidney Failure, Chronic / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000208:ethnology; D016017:Odds Ratio; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D044465:White People