ASIAN adults, more specifically Filipino ethnic subgroups are at highest risk of albuminuria, in patients with diabetes and normal kidney function. Joan Lo, of the Kaiser Permanente Division of Research in California, Oakland, USA, led this published research and stressed its importance. “Albumin in the urine is the first indicator that a patient has diabetic kidney disease,” Lo said. “Knowing there are higher risk groups creates potential for more awareness among physicians about screening and interventions.”
Conducting a retrospective analysis, this report included 79,184 adults aged 45–74 years with diabetes, and normal kidney function and investigated a range of ethnicities. A preserved glomerular filtration rate of 60 mL/min/1.73m2 or higher, and albuminuria assessment, was also necessary in the participants; collected using data from the Kaiser Permanente Northern California Diabetes Registry. Race and ethnicity were self-reported in this cohort, with microalbuminuria defined as a urine-to-creatinine ratio of 30–299 mg/g, and macroalbuminuria the same measure but 300 mg/g or higher. In total, 40.3% of the patients were non-Hispanic white, 26.3% were Asian or Pacific Islander, 21% were Hispanic, and 9.6% were Black.
Normal albumin-to-creatinine ratios were observed in 81.7% of the cohort, while 13.8% had microalbuminuria and 4.6% had macroalbuminuria. Prevalence of albuminuria was found to be higher in Asian (21.1%), Black (18.6%), and Hispanic (17.6%) groups, compared with the White (16.8%) population. Adjusting for covariates, Asian and Pacific Islander adults had the highest risk for albuminuria (adjusted risk ratio [RR]: 1.45; 95% confidence interval [CI]: 1.39–1.50), but no increased risk was observed in Black or Hispanic subgroups. Filipino adults had a higher risk for albuminuria than Chinese adults (adjusted RR: 1.116; 95% CI: 1.07–1.24), while South Asian adults (adjusted RR: 0.72; 95% CI: 0.64–0.82) and Japanese adults (RR: 0.83; 95% CI: 0.72–0.96) experienced a slightly lower risk.
Lo described the usefulness of their findings: “It is important to have this information because early diabetic kidney disease is a condition that can be managed with medication and lifestyle modification.” The researchers urge future study to analyse Asian ethnicity subgroups further to expand on this knowledge.
