Racial and ethnic differences in albuminuria in individuals with estimated GFR greater than 60 mL/min/1.73 m(2): results from the Kidney Early Evaluation Program (KEEP).
BACKGROUND
Albuminuria is an important marker for chronic kidney disease and progression to end-stage renal disease in the general population; understanding racial and ethnic differences can help inform efforts to reduce health disparities. We sought to estimate independent associations of race/ethnicity with albuminuria to determine whether observed differences were attributable to known kidney disease risk factors.


METHODS
This cross-sectional study included 64,161 Kidney Early Evaluation Program (KEEP) participants, 2000-2008, with estimated glomerular filtration rate > or = 60 mL/min/1.73 m(2), not on regular dialysis therapy, and without a previous kidney transplant. Albuminuria (urine albumin-creatinine ratio > or = 30 mg/g) was examined by self-reported race and ethnicity. Covariates were age, sex, educational level, body mass index, diabetes status or glucose level, hypertension status or blood pressure measurement, smoking status, health insurance status, and geographic region.


RESULTS
Albuminuria prevalences were 8% (n = 2,303) in whites, 11% (n = 2,310) in African Americans, 9% (n = 730) in Hispanics, 10% (n = 381) in Asians, and 15% (n = 344) in American Indians/Alaska Natives. Compared with whites, odds of albuminuria were higher for all groups after multivariate adjustment. Odds were highest for American Indians/Alaska Natives (adjusted OR, 1.93; 95% CI, 1.70-2.20), then Asians (adjusted OR, 1.42; 95% CI, 1.26-1.61), African Americans (adjusted OR, 1.38; 95% CI, 1.29-1.47), and Hispanics (adjusted OR, 1.19; 95% CI, 1.08-1.31).


CONCLUSIONS
In the KEEP study population, albuminuria prevalence was higher in African Americans, Hispanics, Asians, and American Indians/Alaska Natives than in non-Hispanic whites, suggesting a need for screening for early detection of kidney damage, especially in people at increased risk, in the community primary care setting.
Jolly
Stacey E
SE
General Internal Medicine, Cleveland Clinic Medicine Institute, Cleveland, OH.
Burrows
Nilka Ríos
NR
Chen
Shu-Cheng
SC
Li
Suying
S
Jurkovitz
Claudine T
CT
Narva
Andrew S
AS
Norris
Keith C
KC
Shlipak
Michael G
MG
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology; D003153:Community Health Services / Q000379:methods / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D005582:Foundations; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D044469:Racial Groups / Q000208:ethnology*; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000208:ethnology