Level and Determinants of Kidney Function in a South Asian Population in Pakistan
Level and Determinants of Kidney Function in a South Asian Population in Pakistan
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DOI：
10.1053/j.ajkd.2011.06.012
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发表时间：
2011-11-01
影响因子：
13.2
通讯作者：
Levey, Andrew S.
中科院分区：
文献类型：
--
作者：
Jafar, Tazeen H.;Islam, Muhammad;Levey, Andrew S.
背景：南亚裔人群患慢性肾脏病的风险很高。一些人认为，南亚人的肾小球滤过率（GFR）通常水平可能低于欧洲血统人群。然而，尚未对南亚裔一般成年人群中测量的 GFR 进行研究。设计：横断面观察研究。背景和参与者：使用多阶段整群抽样从巴基斯坦卡拉奇的社区中随机抽取 530 名 40 岁或以上的患者。排除同时患有糖尿病和高血压的患者。预测因素：年龄、性别、糖尿病和高血压。结果：使用尿菊粉清除率测量 GFR。结果：参与者的平均年龄为 49.7 +/- 9.5（标准差 [SD]）岁，51% 为男性，34.9% 患有高血压，30.5% 患有糖尿病。测量的平均 GFR 为 94.1 +/- 28.6 mL/min/1.73 m(2)。每增加 1 岁，GFR 就会降低 0.79 +/- 0.11 mL/min/1.73 m(2)。研究人群的 5 岁特定年龄和性别平均 GFR 通常与之前报告的美国成年人值的平均值相差 1 个标准差以内。与 GFR 独立相关的因素包括年龄较小（β 系数，每增加 5 岁，β 系数 -3.84 [95% CI，-5.46 至 -2.21] mL/min/1.73 m(2)）、较高的血清白蛋白水平（每增加 0.5 g/dL，4.58 [95% CI，0.74-8.42] mL/min/1.73 m(2)）、较高的空腹血糖水平（每增加 10 mg/dL，0.81 [95% CI，0.44-1.18] mL/min/1.73 m(2)），高肉类摄入量与低肉类摄入量（≥ 11 时为 7.81 [95% CI，1.14-14.48] mL/min/1.73 m(2)）
Background: People of South Asian origin are at high risk of chronic kidney disease. Some have suggested that the usual level of glomerular filtration rate (GFR) in South Asians may be lower than in populations of European origin. However, measured GFR in a general adult population of South Asian origin has not been studied.Design: Cross-sectional observational study.Setting & Participants: 530 patients 40 years or older randomly selected from communities in Karachi, Pakistan, using multistage cluster sampling. Patients with both diabetes and hypertension were excluded.Predictor: Age, sex, diabetes, and hypertension.Outcome: Measured GFR using urinary clearance of inulin.Results: Mean age of participants was 49.7 +/- 9.5 (standard deviation [SD]) years, 51% were men, 34.9% had hypertension, and 30.5% had diabetes. Mean measured GFR was 94.1 +/- 28.6 mL/min/1.73 m(2). GFR was lower by 0.79 +/- 0.11 mL/min/1.73 m(2) for each 1-year older age. The 5-year age- and sex-specific mean GFR of the study population generally was within 1 SD of the mean of previously reported values for US adults. Factors independently associated with GFR were younger age (beta coefficient, -3.84 [95% CI, -5.46 to -2.21] mL/min/1.73 m(2) per 5 years older), higher serum albumin level (4.58 [95% CI, 0.74-8.42] mL/min/1.73 m(2) per 0.5-g/dL increase), higher fasting plasma glucose level (0.81 [95% CI, 0.44-1.18] mL/min/1.73 m(2) per 10-mg/dL increase), high versus low meat intake (7.81 [95% CI, 1.14-14.48] mL/min/1.73 m(2) for >= 11 vs