Study Protocol: accurate assessment of kidney function in Indigenous Australians: aims and methods of the eGFR Study

Maple-Brown, Louise J., Lawton, Paul D., Hughes, Jaquelyne T., Sharma, Suresh K., Jones, Graham R.D., Ellis, Andrew G., Hoy, Wendy, Cass, Alan, MacIsaac, Richard J., Sinha, Ashim K., Thomas, Mark A.B., Piers, Leonard S., Ward, Leigh C., Drabsch, Katrina, Panagiotopoulos, Sianna, McDermott, Robyn, Warr, Kevin, Cherian, Sajiv, Brown, Alex, Jerums, George, and O'Dea, Kerin (2010) Study Protocol: accurate assessment of kidney function in Indigenous Australians: aims and methods of the eGFR Study. BMC Public Health, 10. 80. pp. 1-11.

[img]
Preview
PDF (Published Version) - Published Version
Available under License Creative Commons Attribution.

Download (260kB) | Preview
View at Publisher Website: http://dx.doi.org/10.1186/1471-2458-10-8...
 
26
82


Abstract

Background: There is an overwhelming burden of cardiovascular disease, type 2 diabetes and chronic kidney disease among Indigenous Australians. In this high risk population, it is vital that we are able to measure accurately kidney function. Glomerular filtration rate is the best overall marker of kidney function. However, differences in body build and body composition between Indigenous and non-Indigenous Australians suggest that creatinine-based estimates of glomerular filtration rate derived for European populations may not be appropriate for Indigenous Australians. The burden of kidney disease is borne disproportionately by Indigenous Australians in central and northern Australia, and there is significant heterogeneity in body build and composition within and amongst these groups. This heterogeneity might differentially affect the accuracy of estimation of glomerular filtration rate between different Indigenous groups. By assessing kidney function in Indigenous Australians from Northern Queensland, Northern Territory and Western Australia, we aim to determine a validated and practical measure of glomerular filtration rate suitable for use in all Indigenous Australians.

Methods/Design: A cross-sectional study of Indigenous Australian adults (target n = 600, 50% male) across 4 sites: Top End, Northern Territory; Central Australia; Far North Queensland and Western Australia. The reference measure of glomerular filtration rate was the plasma disappearance rate of iohexol over 4 hours. We will compare the accuracy of the following glomerular filtration rate measures with the reference measure: Modification of Diet in Renal Disease 4-variable formula, Chronic Kidney Disease Epidemiology Collaboration equation, Cockcroft-Gault formula and cystatin C-derived estimates. Detailed assessment of body build and composition was performed using anthropometric measurements, skinfold thicknesses, bioelectrical impedance and a sub-study used dual-energy X-ray absorptiometry. A questionnaire was performed for socio-economic status and medical history.

Discussion: We have successfully managed several operational challenges within this multi-centre complex clinical research project performed across remote North, Western and Central Australia. It seems unlikely that a single correction factor (similar to that for African-Americans) to the equation for estimated glomerular filtration rate will prove appropriate or practical for Indigenous Australians. However, it may be that a modification of the equation in Indigenous Australians would be to include a measure of fat-free mass.

Item ID: 35796
Item Type: Article (Research - C1)
ISSN: 1471-2458
Additional Information:

© 2010 Maple-Brown et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funders: National Health and Medical Research Council of Australia (NHMRC), Kidney Health Australia, Colonial Foundation, Rebecca L. Cooper Foundation, SeaSwift, University of Melbourne
Projects and Grants: NHMRC Project Grant #545202, NHMRC Project Grant #320860
Date Deposited: 15 Oct 2014 16:48
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111701 Aboriginal and Torres Strait Islander Health @ 100%
SEO Codes: 92 HEALTH > 9203 Indigenous Health > 920301 Aboriginal and Torres Strait Islander Health - Determinants of Health @ 100%
Downloads: Total: 82
Last 12 Months: 14
More Statistics

Actions (Repository Staff Only)

Item Control Page Item Control Page