Kidney Week

Abstract: TH-PO846

Associations of Risk and Protective Factors with Kidney Outcomes among American Indians: The Strong Heart Family Study

Session Information

• Race, Ethnicity, and Gender in Kidney Health and Care
  October 24, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Diversity and Equity in Kidney Health

• 900 Diversity and Equity in Kidney Health

Authors

• Mokiao, Reya H., University of Washington School of Medicine, Seattle, Washington, United States

Reya H. Mokiao, MD, MS

• Carlin, Kristen E., Seattle Children's Research Institute, Seattle, Washington, United States

Kristen E. Carlin, MPH

• Deen, Jason F., University of Washington School of Medicine, Seattle, Washington, United States

Jason F. Deen, MD

• Umans, Jason G., MedStar Health Research Institute, Hyattsville, Maryland, United States

Jason G. Umans, MD, PhD

• Young, Bessie A., University of Washington School of Medicine, Seattle, Washington, United States

Bessie A. Young, MD, MPH, FASN

• Fretts, Amanda M., University of Washington School of Public Health, Seattle, Washington, United States

Amanda M. Fretts, PhD, MPH

Background

Kidney disease disproportionately affects American Indians (AI) compared to White individuals, and it is important to explore modifiable risk factors as potential areas for intervention. The objective of this study was to explore the associations of kidney disease risk factors, achievement of the American Heart Association’s (AHA) Life’s Essential 8 (LE8), and social support with low estimated glomerular filtration rate (eGFR) and albuminuria among AI in the Strong Heart Family Study (SHFS).

Methods

The study population included participants from the SHFS, a longitudinal study of cardiovascular disease (CVD) among AIs from 12 tribes (n=1956, age 39 ± 16 years, 61% female, 13% with diabetes (DM)). Participants completed baseline (2001-2003) and follow-up (2007-2009) exams. The primary exposures were prevalent DM, obesity, hypertension, dyslipidemia, CVD, smoking, diet, physical activity, a modified LE8 score (smoking, body mass index (BMI), lipids, glucose, blood pressure, physical activity, and diet), and social support as risk/ protective factors. The primary outcomes were: 1) incident albuminuria (albumin to creatinine ratio 30mg/g or greater); 2) incident low eGFR (eGFR < 90 ml/min/1.73m² using the 2021 CKD-EPI Creatinine equation). Generalized estimating equations were used to examine the association of all exposures with outcomes.

Results

In this relatively young cohort of AI, kidney disease risk factors were common. Based on LE8 scores, 14%, 71% and 15% had low, moderate, and optimal CVD health respectively. At follow up, 10% had incident albuminuria and 8% had incident low eGFR. Higher BMI (OR 1.04, 95%CI 1.01, 1.07, p<0.01) and DM (OR 2.94, 95%CI 1.84, 4.67, p< 0.0001) were associated with incident albuminuria. Those with moderate (0.57, 95%CI 0.39, 0.84, p<0.01) and high (OR 0.30, 95%CI 0.16, 0.58, p<0.001) compared to those with low CVD health based on LE8 scores had decreasing odds of incident albuminuria. None of the exposures were associated with incident low eGFR.

Conclusion

Although kidney disease risk factors were prevalent among the SHFS cohort, adherence to the AHA’s LE8 was associated with lower odds of incident albuminuria. Preventative interventions that promote and facilitate adherence to healthy behaviors, like LE8, may improve cardiovascular and kidney health among AIs.

Funding

• Other NIH Support