Level and determinants of kidney function in a South Asian population in Pakistan.
Journal Article (Journal Article)
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 (β 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 ≤5 servings/wk), and higher estimated protein intake (1.46 [95% CI, 0.41-2.51] mL/min/1.73 m(2) per 1.0-g/d increase) from urine urea nitrogen.Limitations
Moderate sample size, lack of validation of some items in the dietary assessment for this study population.Conclusions
Mean measured GFR in South Asian adults from the general population in Karachi, Pakistan, is only modestly lower than in European-origin counterparts, with similar age association. This may reflect lower dietary protein intake in South Asians.Full Text
Duke Authors
Cited Authors
- Jafar, TH; Islam, M; Jessani, S; Bux, R; Inker, LA; Mariat, C; Levey, AS
Published Date
- November 2011
Published In
Volume / Issue
- 58 / 5
Start / End Page
- 764 - 772
PubMed ID
- 21840098
Pubmed Central ID
- PMC4414013
Electronic International Standard Serial Number (EISSN)
- 1523-6838
International Standard Serial Number (ISSN)
- 0272-6386
Digital Object Identifier (DOI)
- 10.1053/j.ajkd.2011.06.012
Language
- eng