Natural history of chronic kidney disease in Australian Indigenous and non-Indigenous children: a 4-year population-based follow-up study

Med J Aust. 2009 Mar 16;190(6):303-6. doi: 10.5694/j.1326-5377.2009.tb02417.x.

Abstract

Objective: To describe the natural history and risk of early chronic kidney disease (CKD) in Indigenous Australian populations.

Design, setting and participants: A prospective cohort of 2266 Aboriginal and non-Aboriginal children enrolled from primary schools throughout New South Wales from February 2002 to June 2004 and followed for 4 years.

Main outcome measures: Urinalysis, height, weight, blood pressure, birthweight and sociodemographic status at baseline and 2- and 4-year follow-up; CKD risk factors: haematuria, albuminuria, obesity, and systolic and diastolic hypertension.

Results: 2266 children (55% Aboriginal; 51% male; mean age, 8.9 years [SD, 2.0 years]) were enrolled at baseline. 1432 children (63%) were retested at 2-year follow-up, and 1506 children (67%) at 4-year follow-up. Prevalence of baseline CKD risk factors was frequent (2%-7%), but most abnormalities were transient. Besides persistent obesity (5.0%), persistence of CKD risk factors at final follow-up was low: haematuria (1.9%), albuminuria (2.4%), systolic hypertension (1.5%) and diastolic hypertension (0.2%). There was no difference in prevalence of persistent CKD risk factors between Aboriginal and non-Aboriginal children.

Conclusions: Over 4 years of follow-up, Indigenous Australian children had no increased risk for early evidence of CKD. More than 70% of baseline risk factors were transient, and persistent risk factors were uncommon. Our findings suggest the increased risk for end-stage kidney disease seen in Indigenous adults is not yet manifest in these schoolchildren, and may be potentially preventable.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Albuminuria / complications
  • Albuminuria / epidemiology
  • Albuminuria / ethnology
  • Child
  • Child, Preschool
  • European Continental Ancestry Group
  • Female
  • Hematuria / complications
  • Hematuria / epidemiology
  • Hematuria / ethnology
  • Humans
  • Hypertension / complications
  • Hypertension / epidemiology
  • Hypertension / ethnology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / ethnology
  • Male
  • New South Wales / epidemiology
  • Obesity / complications
  • Obesity / epidemiology
  • Obesity / ethnology
  • Oceanic Ancestry Group
  • Odds Ratio
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Socioeconomic Factors