Saydah SH, et al. - Researchers analyzed the trends in albuminuria and estimated glomerular filtration rate (eGFR) among adolescents in the United States between 1988 and 2014. They found that during this time period, no significant change had been observed in the albuminuria prevalence in the US adolescent population. Findings revealed that in the most recent study period, higher prevalences of both reduced and low eGFRs were reported; however, low eGFRs were detected in < 1% of adolescents.

Methods

• Researchers performed serial cross-sectional national surveys.
• Participants were adolescents aged 12 to 18 years participating in the National Health and Nutrition Examination Surveys 1988 to 2014.
• They grouped surveys into three 6-year periods.
• Demographic and clinical determinants of kidney markers were examined as predictors.
• Prevalence and trends in persistent albuminuria, low (< 60mL/min/1.73m²) and reduced (< 90mL/min/1.73m²) eGFRs were included as outcome.
• Outcomes defined as persistent albumin-creatinine ratio ≥ 30mg/g (persistent albuminuria), eGFR < 90mL/min/1.73m² (reduced kidney function), and eGFR < 60mL/min/1.73m² (low kidney function).
• They used multiple imputation analysis to estimate missing follow-up values of albuminuria.

Results

• The estimated prevalences of persistent albuminuria in 1988-1994 and in 2009-2014 were 3.64% (95% CI, 1.82%-5.46%) and 3.29% (95% CI, 1.94%-4.63%), respectively (adjusted prevalence ratio, 0.93; 95% CI, 0.53-1.62; P=0.8 for trend).
• Findings revealed that the reported prevalences of reduced eGFR were 31.46% (95% CI, 28.42%-34.67%) and 34.58% (95% CI, 32.07%-37.18%), respectively, (adjusted prevalence ratio, 1.21; 95% CI, 1.00-1.46; P < 0.001 for trend).
• In 1988-1994 and in 2009-2014, the reported prevalences of low eGFR were 0.32% (95% CI, 0.12%-0.84%) and 0.91% (95% CI, 0.58%-1.42%), respectively, (adjusted prevalence ratio, 3.10; 95% CI, 1.10-9.01; P=0.09 for trend).
• Data showed that prevalences of albuminuria and/or low eGFR continued to be at 4.0% in 1988-1994 and 2009-2014 (adjusted prevalence ratio, 1.06; 95% CI, 0.64-1.77; P=0.8 for trend).