Kidney Week

Abstract: SA-PO772

High Instead of Lower CKD-EPI-Based eGFR Values in Dutch Ethnic Minorities at Risk for CKD

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - III
  October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Huisman, Brechje, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Brechje Huisman,

• Agyemang, Charles, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Charles Agyemang,

• Hafkamp, Bram, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Bram Hafkamp,

• Van den born, Bert-jan, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Bert-jan Van den born,

• Peters, Ron, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Ron Peters,

• Snijder, Marieke, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Marieke Snijder,

• Vogt, Liffert, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands

Liffert Vogt,

Background

According to the widely adopted KDIGO guidelines, classification of chronic kidney disease (CKD) and evaluation of prognosis is based on two components: estimated glomerular filtration rate (eGFR) and urinary albumin-to-creatinine ratio (ACR). This approach has, however, never been validated for various ethnic groups living in the Netherlands and might lead to uncertainty in CKD staging. We investigated to what extent ethnic differences in eGFR and ACR can be explained by differences in demographics and traditional cardiovascular risk factors.

Methods

Baseline data from the HELIUS study, a multi-ethnic cohort study conducted in the city of Amsterdam, were used. Analyses were conducted among 18,534 participants (aged 18-70 years) of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Moroccan and Turkish ethnic origin. We used multiple regression analyses to determine ethnic differences in eGFR (CKD-EPI formula) and ACR, with additional adjustments for age, sex, traditional cardiovascular and kidney risk factors, and educational level.

Results

Mean (SE) eGFR was higher in all ethnic minority groups as compared to those of Dutch origin (eGFR 94.9±0.3 mL/min/1.73m²), ranging from 1.9±4.1 in subjects from South-Asian Surinamese origin to 15.0±0.39 in subjects from Moroccan origin. Also, ACR was higher among all ethnic minorities as compared to those of Dutch origin (ACR 0.6±0.2 mg/mmol), ranging from 0.5±0.2 in subjects from African Surinamese origin to 1.7±0.2 in subjects from South-Asian Surinamese origin. Adjustment for age, sex, traditional cardiovascular and kidney risk factors diminished the differences in both eGFR and ACR for most ethnic groups but these differences were still highly significant.

Conclusion

Our results show that eGFR is higher among ethnic minority groups as compared to those from Dutch origin. Regarding previously found higher CKD prevalence in ethnic minority groups of HELIUS, these findings underscore the need for ethnicity specific GFR estimations, as the currently recommended use of the CKD-EPI-based eGFR, which only distinguishes 2 ethnic groups, might lead to an underestimation of risk in multi-ethnic populations. Given the observed higher ACR values among minority groups, ACR might represent a more useful risk factor in multi-ethnic populations.