title: Prevalence, risk factors and awareness of albuminuria on a Canadian First Nation: a community-based screening study.
abstract: BACKGROUND
  Both diabetic and non-diabetic end stage renal disease (ESRD) are more common among Canadian First Nations people than among the general Canadian population. The purpose of this research was to determine the prevalence of and risk factors for albuminuria in a Canadian First Nation population at high risk for ESRD and dialysis.
  
  
  METHODS
  Data from a community-based screening study of 483 residents of a Plains Ojibway First Nation in Manitoba was used. Participants provided random urine samples. Proteinuria was defined as any dipstick positive for protein (≥1 g/L) or those with ACR in the macroalbuminuric range (≥30 mg/mmol) on at least one sample. Microalbuminuria was defined as ACR ≥2 mg/mmol for males and ≥2.8 mg/mmol for females. Other measures included fasting glucose, haemoglobin A1c, triglycerides, cholesterol, blood pressure, height, weight and waist and hip circumferences.
  
  
  RESULTS
  Twenty percent of study participants had albuminuria, (5% proteinuria and 15% microalbuminuria). Of participants with diabetes, 42% (56/132) had albuminuria compared to 26% (7/27) among those with impaired fasting glucose and 10% (30/303) among those with normal glucose tolerance. Only 5.3% of those with albuminuria were aware of any degree of renal disease. In a multivariate logistic regression, independent associations with albuminuria were male gender [p = 0.002], increasing fasting glucose [p <0.0001], years diagnosed with diabetes [p = 0.03], increasing systolic blood pressure [p = 0.009], and increasing body mass index (BMI) [p = 0.04].
  
  
  CONCLUSIONS
  The independent association between BMI and albuminuria has not been previously reported among indigenous populations. There is a high prevalence of albuminuria in this Canadian First Nation population; the high proportion of patients with diabetes and undiagnosed kidney disease demonstrates the need for screening, education and intervention to halt the progression and development of albuminuria and ultimately ESRD and CVD.
authors.affiliation: Section of Nephrology, Department of Internal Medicine, Health Sciences Centre, University of Manitoba, Winnipeg, Manitoba R3A 1R9, Canada. jzacharias@exchange.hsc.mb.ca
authors.forename: James Michael
authors.initials: JM
authors.lastname: Zacharias
authors.forename: T Kue
authors.initials: TK
authors.lastname: Young
authors.forename: Natalie D
authors.initials: ND
authors.lastname: Riediger
authors.forename: Joanne
authors.initials: J
authors.lastname: Roulette
authors.forename: Sharon G
authors.initials: SG
authors.lastname: Bruce
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000175:diagnosis* / Q000208:ethnology / Q000628:therapy; D003153:Community Health Services / Q000379:methods*; D003404:Creatinine / Q000652:urine; D048909:Diabetes Complications / Q000175:diagnosis* / Q000208:ethnology / Q000517:prevention & control / Q000628:therapy; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000208:ethnology / Q000523:psychology; D005215:Fasting / Q000097:blood; D005260:Female; D018149:Glucose Intolerance / Q000150:complications; D006442:Glycated Hemoglobin / Q000378:metabolism; D007722:Health Knowledge, Attitudes, Practice; D006303:Health Services, Indigenous / Q000706:statistics & numerical data; D006801:Humans; D007198:Indians, North American / Q000523:psychology* / Q000706:statistics & numerical data; D007676:Kidney Failure, Chronic / Q000453:epidemiology; D007677:Kidney Function Tests; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D015995:Prevalence; D011507:Proteinuria / Q000175:diagnosis; D006435:Renal Dialysis / Q000523:psychology; D012307:Risk Factors
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin