Abstract:
BACKGROUND:Detection of chronic kidney disease (CKD) with urine albumin-to-creatinine ratio (UACR) among patients with hypertension (HTN) provides an opportunity for early treatment, potentially mitigating risk of CKD progression and cardiovascular complications. Differences in UACR testing patterns among racial/ethnic populations at risk for CKD could contribute to known disparities in CKD complications. METHODS:We examined the prevalence of UACR testing among low-income adult primary care patients with HTN, defined by a new administrative code for HTN or 2 clinic blood pressures >140/90 mm Hg between January 1, 2014, and January 1, 2017, in one public health-care delivery system with a high prevalence of end-stage kidney disease among race/ethnic minorities. Logistic regression was used to identify odds of UACR testing within 1 year of a HTN diagnosis, overall, and by racial/ethnic subgroup, adjusted for demographic factors, estimated glomerular filtration rate, and HTN severity. Models were also stratified by diabetes status. RESULTS:The cohort (n = 16,414) was racially/ethnically diverse (16% White, 21% Black, 34% Asian, 19% Hispanic, and 10% other) and 51% female. Only 35% of patients had UACR testing within 1 year of a HTN diagnosis. Among individuals without diabetes, odds of UACR testing were higher among Asians, Blacks, and Other subgroups compared to Whites (adjusted OR [aOR] 1.19; 95% CI 1.00-1.42 for Blacks; aOR 1.33; 1.13-1.56 for Asians; aOR 1.30; 1.04-1.60 for Other) but were not significantly different between Hispanics and Whites (aOR 1.17; 0.97-1.39). Among individuals with diabetes, only Asians had higher odds of UACR testing compared to Whites (aOR 1.35; 1.12-1.63). CONCLUSIONS:Prevalence of UACR testing among low-income patients with HTN is low in one public health-care delivery system, with higher odds of UACR testing among racial/ethnic minority subgroups compared to Whites without diabetes and similar odds among those with diabetes. If generalizable, less albuminuria testing may not explain higher prevalence of kidney failure in racial/ethnic minorities.
journal_name
Am J Nephroljournal_title
American journal of nephrologyauthors
Lee J,Chu C,Guzman D,Fontil V,Velasquez A,Powe NR,Tuot DSdoi
10.1159/000500706subject
Has Abstractpub_date
2019-01-01 00:00:00pages
48-54issue
1eissn
0250-8095issn
1421-9670pii
000500706journal_volume
50pub_type
杂志文章abstract:BACKGROUND:Contemporary prevalence of chronic kidney disease (CKD) and thrombotic cardiovascular (CV) events remains unclear in Veterans enrolled in the Veterans Affairs Health Care System (VA) care. Although oral P2Y12 inhibitors (P2Y12i) are increasingly being prescribed to this patient population, the overall prescr...
journal_title:American journal of nephrology
pub_type: 杂志文章
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abstract::Ion-selective electrodes have been designed for determining the ionized concentration of magnesium in blood, the biologically active form of this ion. The effect of acute acidosis induced by ammonium loading on circulating and urinary magnesium was investigated in 11 volunteers. No changes in plasma total and ionized ...
journal_title:American journal of nephrology
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doi:10.1159/000013342
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abstract::To elucidate the relationship between the renal regulation of sodium and calcium excretion at extremes of sodium intake, we studied 6 normal men ingesting a fixed, 400 mg/day calcium intake and four levels of sodium intake from 10 to 1,500 mEq/day. Serum ionized calcium was not influenced by sodium intake. Blood press...
journal_title:American journal of nephrology
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abstract::The development of new therapies for chronic diseases, such as diabetic kidney disease (DKD), will continue to be hampered by lack of sufficient biomarkers that will provide insights and will be responsive to treatment interventions. The recent application of metabolomic technologies, such as nuclear magnetic resonanc...
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abstract::The influence of fluvastatin, a liver-selective, competitive inhibitor of the 3-hydroxymethyl-glutaryl-coenzyme A reductase, on the lipoprotein metabolism was investigated in 9 patients with nephrotic syndrome. All patients had biopsy-proven renal disease as cause of their nephrotic syndrome and exhibited severe hyper...
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pub_type: 杂志文章,随机对照试验
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abstract:BACKGROUND:Persons with chronic kidney disease (CKD) represent a population prone to cardiovascular disease (CVD) but vulnerable to adverse medication effects. We assessed the impact of intensive antihypertensive therapy on the cerebrovascular and other CVD outcomes in high-risk patients with type 2 diabetes and baseli...
journal_title:American journal of nephrology
pub_type: 杂志文章,多中心研究,随机对照试验
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abstract:BACKGROUND:Tacrolimus (FK) is currently widely used in transplant immunosuppression and the treatment of autoimmune diseases. However, FK induces nephrotoxicity which is characterized by functional and structural renal injury. The ubiquitous protein annexin A1 (ANXA1) has potent anti-inflammatory effects and protects a...
journal_title:American journal of nephrology
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
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journal_title:American journal of nephrology
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doi:10.1159/000086080
更新日期:2005-05-01 00:00:00
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更新日期:2013-01-01 00:00:00
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pub_type: 杂志文章
doi:10.1159/000082946
更新日期:2004-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1159/000013351
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journal_title:American journal of nephrology
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journal_title:American journal of nephrology
pub_type: 临床试验,杂志文章
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更新日期:2014-01-01 00:00:00
abstract::Several medical inventors in Europe and North America brought the artificial kidney (hemodialysis) to practical usefulness in the late 1940s, but there were very few early successes. It was used at first for only desperate cases of acute renal failure. Renal authorities in the 'metabolic' tradition favored newly quant...
journal_title:American journal of nephrology
pub_type: 历史文章,杂志文章
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更新日期:1997-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:Clinical indicators for accurately distinguishing diabetic nephropathy (DN) from non-diabetic renal disease in type 2 diabetes (T2D) are lacking. This study aimed to develop and validate a nomogram for predicting DN in T2D patients with kidney disease. METHODS:A total of 302 consecutive patients with T2D wh...
journal_title:American journal of nephrology
pub_type: 杂志文章
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更新日期:2020-01-01 00:00:00
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journal_title:American journal of nephrology
pub_type: 传,历史文章,杂志文章
doi:10.1159/000013463
更新日期:1999-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2013-01-01 00:00:00
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pub_type: 临床试验,杂志文章
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abstract:BACKGROUND:Since low-density lipoprotein (LDL) S-homocysteinylation has been recently reported to enhance atherogenicity of lipoprotein, we have investigated the levels of homocysteine (Hcy) linked to LDL in chronic proteinuric patients in which lipid abnormalities highly contribute to the excess of morbidity and morta...
journal_title:American journal of nephrology
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