Supplementary Material for: Insights from Screening a Racially and Ethnically Diverse Population for Chronic Kidney Disease

<b><i>Background:</i></b> The value of chronic kidney disease (CKD) screening in the general population remains unclear but may be beneficial in populations with high disease prevalence. We examined risk factors for albuminuria among participants in a state-wide CKD screening program in Hawaii. <b><i>Methods:</i></b> The National Kidney Foundation of Hawaii Kidney Early Detection Screening (NKFH-KEDS) program held 19 CKD screening events from 2006 to 2012. Participants rotated through 5 stations during which sociodemographic, blood glucose, urine albumin-to-creatinine ratio (ACR), and spot urine albumin data were collected. Multivariate logistic regression analyses (adjusted for age, sex, race/ethnicity, body mass index [BMI]) were used to identify clinical predictors of abnormal ACR (≥30 μg/mg) and abnormal spot urine albumin (&gt;20 mg/L) levels. <b><i>Results:</i></b> Among 1,190 NKFH-KEDS participants who met eligibility criteria, 13 and 49% had abnormal ACR and urine albumin levels, respectively. In multivariate logistic regression analyses, participants of older age (&gt;65 years), Asian and Pacific Islander race/ethnicity, BMI ≥30 kg/m², and with hypertension had higher risk of abnormal ACR. Being of older age; Asian, Pacific Islander, and Mixed race/ethnicity; and having diabetes was associated with higher risk of abnormal urine albumin levels in adjusted analyses. <b><i>Conclusions:</i></b> NKFH-KEDS participants of older age; Asian and Pacific Islander race/ethnicity; and with obesity, hypertension, and diabetes had higher risk of kidney damage defined by elevated ACR and urine albumin levels. Further studies are needed to determine whether targeted screening programs can result in timely identification of CKD and implementation of interventions that reduce cardiovascular disease, death, and progression to end-stage renal disease.

<b><i>研究背景：</i></b> 慢性肾脏病（Chronic Kidney Disease, CKD）在普通人群中的筛查价值尚不明确，但在疾病患病率较高的人群中可能具有临床获益。本研究针对夏威夷州范围内的CKD筛查项目参与者，分析了白蛋白尿（Albuminuria）的危险因素。<b><i>研究方法：</i></b> 夏威夷全国肾脏基金会肾脏早期检测筛查（National Kidney Foundation of Hawaii Kidney Early Detection Screening, NKFH-KEDS）项目于2006至2012年间开展了19场CKD筛查活动。参与者依次完成5个检测工位的流程，采集其社会人口学特征、血糖、尿白蛋白肌酐比（Urine Albumin-to-Creatinine Ratio, ACR）以及随机尿白蛋白相关数据。本研究采用多因素logistic回归分析（校正年龄、性别、种族/民族、体质量指数[Body Mass Index, BMI]），分别明确ACR≥30 μg/mg以及随机尿白蛋白＞20 mg/L这两项指标异常的临床预测因素。<b><i>研究结果：</i></b> 符合入组标准的1190名NKFH-KEDS项目参与者中，分别有13%和49%的人群出现ACR异常与尿白蛋白水平异常。多因素logistic回归分析结果显示，年龄＞65岁、亚裔/太平洋岛民族群、体质量指数≥30 kg/m²以及合并高血压的参与者，其ACR异常风险更高。校正分析显示，高龄、亚裔/太平洋岛民/混血族群以及合并糖尿病的人群，其随机尿白蛋白水平异常的风险更高。<b><i>研究结论：</i></b> 符合上述特征的NKFH-KEDS项目参与者，其ACR与尿白蛋白水平升高所定义的肾脏损伤风险更高。未来仍需开展进一步研究，以明确针对性筛查项目能否实现CKD的及时检出，并落实可降低心血管疾病、死亡以及终末期肾病进展风险的干预措施。