BJ Orr-Walker
Ethnic differences in 25-year risk of incident chronic kidney disease among people with type 2 diabetes in New Zealand
Orr-Walker, BJ; Yu, D; Wang, Z; Cai, Y; Osuagwu, UL; Pickering, K; Baker, J; Cutfield, R; Sundborn, G; Jayanatha, K; Zhao, Z; Simmons, D
Authors
Dr. Dahai Yu d.yu@keele.ac.uk
Z Wang
Y Cai
UL Osuagwu
K Pickering
J Baker
R Cutfield
G Sundborn
K Jayanatha
Z Zhao
D Simmons
Abstract
INTRODUCTION: Insights into ethnic differences in the natural history of chronic kidney disease (CKD) among people with type 2 diabetes mellitus (T2DM) might inform clinical strategies to address disparities in hospitalization and mortality. Risks of CKD II-V stages over a 25-year period between New Zealand Europeans (NZEs), Maori and Pasifika, and with T2DM in Auckland, New Zealand (NZ) were compared. RESEARCH DESIGN AND METHODS: As a primary care audit program in Auckland, the Diabetes Care Support Service was linked with national registration databases. People with existing CKD II-V were ruled out. To balance potential confounders, we applied a tapered matching method . 'Quasi-trial'-matched cohorts were set up separately between Maori and NZE and between Pasifika and NZE. Ethnic population differences in risk of any and each stage of CKD over 1994-2018 were examined by weighted Cox regression model. RESULTS: The HRs for developing any CKD, CKD stages II-V for Maori (n=2215) versus NZE (n=2028) were 1.18 (95% CI 0.99 to 1.41), 1.10 (95% CI 0.91 to 1.32), 1.70 (95% CI 1.19 to 2.43), 3.93 (95% CI 2.16 to 7.14), and 3.74 (95% CI 1.74 to 8.05), respectively. Compared with NZE (n=2474), the HRs for developing any CKD, CKD stages II-V for Pasifika (n=3101) were 1.31 (95% CI 1.09 to 1.57), 1.26 (95% CI 1.05 to 1.52), 1.71 (95% CI 1.14 to 2.57), 3.75 (95% CI 1.40 to 10.05), and 4.96 (95% CI 1.56 to 15.75), respectively. CONCLUSIONS: Among people with T2DM in NZ, significant ethnic differences exist in the risk of progressing to each stage of CKD (stage V in particular). Mechanism studies underlying these differences, as well as the need for identification of biomarkers to predict the early onset renal lesion, are warranted.
Journal Article Type | Article |
---|---|
Acceptance Date | Oct 14, 2022 |
Publication Date | Dec 15, 2022 |
Publicly Available Date | May 30, 2023 |
Journal | BMJ Open Diabetes Research & Care |
Publisher | BMJ Publishing Group |
DOI | https://doi.org/10.1136/bmjdrc-2022-003077 |
Keywords | Type 2 Diabetes; Ethnic Groups; Kidney Failure; Chronic; Cohort Studies |
Publisher URL | https://drc.bmj.com/content/10/6/e003077 |
Additional Information | © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
Files
e003077.full.pdf
(2.3 Mb)
PDF
Publisher Licence URL
https://creativecommons.org/licenses/by-nc/4.0/