Background: Little is known about the causes and consequences of renal disease among American Indians in the Great Lakes region of the United States.
Methods: We examined clinical correlates of albumin/creatinine ratios among 1368 participants in the three tribal communities of the Inter-Tribal Heart Project using univariate and multivariate analysis.
Results: Compared to 1086 participants without albuminuria, the 240 with microalbuminuria (30 to 299 mg/g) and the 42 with macroalbuminuria (>300 mg/g) were more likely to report a history of a myocardial infarction (6.4%, 16.0%, and 23.8%, respectively, P < 0.001). Similarly, compared to patients without albuminuria, those with microalbuminuria and macroalbuminuria were more likely to report a history of stroke (2.3%, 8.4% and 26.2%, respectively, P < 0.001). In a multiple linear regression model, independent correlates of albumin excretion (P < 0.05) included: fasting blood sugar, treated diabetes, treated hypertension, higher systolic blood pressure, lower diastolic blood pressure, abnormal electrocardiogram, a history of stroke, the degree of American Indian heritage, and lower household income.
Conclusions: Urinary albumin excretion is associated with cardiovascular disease outcomes and risk factors among American Indians of the Great Lakes region. Both heredity and socioeconomic status appear to play a role in the pathogenesis of renal injury in this population.