Long-term albuminuria risks among Asian American adults with diabetes differ by ethnicity
Click Here to Manage Email Alerts
Key takeaways:
- Albuminuria risks were most increased for Filipino, Southeast Asian, Japanese and Native Hawaiian/Pacific Islander vs. white adults.
- Risks were lower for Chinese and South Asian vs. other Asian American groups.
Long-term albuminuria risks for U.S. adults with Asian/Pacific Islander ancestry who have diabetes and normal kidney function differ across ethnic subgroups, according to data published in Kidney Medicine.
In 4 years, adults with South Asian ethnicity had the same risk as non-Hispanic white adults, whereas Filipino adults had almost four times increased risk.
“Readers might be surprised to see how heterogenous the Asian and Pacific Islander population is and, therefore, how much more we still need to learn about diabetic kidney disease progression among these adults,” Billy Zeng, MD, an internal medicine resident at Kaiser Permanente Oakland Medical Center told Healio.
To assess albuminuria risk for Asian Americans, Zeng and colleagues analyzed data from 2015 to 2019 from Kaiser Permanente Northern California medical records on 53,676 adults with diabetes. At baseline, 74.6% of the cohort had hypertension, and all patients (mean age, 60.1 years; 53.3% men) had an eGFR at least 60 mL/min/1.73 m2 and a urine albumin-creatinine ratio of less than 30 mg/g. Race and ethnicity were self-reported as the following: non-Hispanic white, 39.9%; Black, 9.6%; Hispanic, 21.5%; Asian/Pacific Islander 26.2%.
At 4 years, 13.5% of the total cohort had albuminuria, including 13.5% of those who identified as non-Hispanic white and 14.2% of those who identified as Asian/Pacific Islander for a 25% increased albuminuria risk for Asian/Pacific Islander vs. white adults after adjustments (RR = 1.25; 95% CI, 1.19-1.31).
However, risk for albuminuria was not equal for different ethnic subgroups.
At 4 years, albuminuria was present for 16.4% of those who identified as Filipino, 14.9% of those who identified as Japanese, 14.6% of those who identified as Southeast Asian, 14.5% of those who identified as Native Hawaiian/Pacific Islander, 13.1% of those who identified as Chinese and 11.4% of those who identified as South Asian. Compared with white adults, South Asian adults had similar risk for albuminuria, whereas risks were higher by 39% for Filipino, 36% for Southeast Asian, 34% for Japanese, 28% for Native Hawaiian/Pacific Islander and 19% for Chinese adults in the U.S.
“These findings support greater monitoring of higher risk groups for early signs of albuminuria, even if their initial kidney function appears normal. Early detection and intervention could potentially delay or prevent the progression to more severe kidney disease and its associated complications,” Zeng said.
“Given the known heterogeneity among Asian and Native Hawaiian/Pacific Islander groups, future research should continue to disaggregate these populations and include more granular data on biological, social and socioeconomic factors to better understand the observed ethnic differences. By addressing these knowledge gaps, future studies can contribute to more targeted and effective prevention and management strategies for diabetic kidney disease in diverse populations,” he said.
Collapse
Click Here to Manage Email Alerts