As a primary care audit program in Auckland, the Diabetes Care Support Service was linked with national registration databases. People with existing CKD II-V were ruled out. To balance potential confounders, we applied a tapered matching method . \'Quasi-trial\'-matched cohorts were set up separately between Māori and NZE and between Pasifika and NZE. Ethnic population differences in risk of any and each stage of CKD over 1994-2018 were examined by weighted Cox regression model.
The HRs for developing any CKD, CKD stages II-V for Māori (n=2215) versus NZE (n=2028) were 1.18 (95% CI 0.99 to 1.41), 1.10 (95% CI 0.91 to 1.32), 1.70 (95% CI 1.19 to 2.43), 3.93 (95% CI 2.16 to 7.14), and 3.74 (95% CI 1.74 to 8.05), respectively. Compared with NZE (n=2474), the HRs for developing any CKD, CKD stages II-V for Pasifika (n=3101) were 1.31 (95% CI 1.09 to 1.57), 1.26 (95% CI 1.05 to 1.52), 1.71 (95% CI 1.14 to 2.57), 3.75 (95% CI 1.40 to 10.05), and 4.96 (95% CI 1.56 to 15.75), respectively.
Among people with T2DM in NZ, significant ethnic differences exist in the risk of progressing to each stage of CKD (stage V in particular). Mechanism studies underlying these differences, as well as the need for identification of biomarkers to predict the early onset renal lesion, are warranted.
方法:作为奥克兰的初级保健审计计划,糖尿病护理支持服务与国家注册数据库相关联.排除了已有CKDII-V的患者。为了平衡潜在的混杂因素,我们应用了锥形匹配方法。分别在毛利人和NZE之间以及Pasifika和NZE之间建立了“准试验”匹配的队列。通过加权Cox回归模型研究了1994-2018年CKD任何阶段和每个阶段的种族人群风险差异。
结果:开发任何CKD的HR,毛利人(n=2215)与NZE(n=2028)的CKDII-V期为1.18(95%CI0.99至1.41),1.10(95%CI0.91至1.32),1.70(95%CI1.19至2.43),3.93(95%CI2.16至7.14),和3.74(95%CI1.74至8.05),分别。与NZE(n=2474)相比,开发任何CKD的HR,Pasifika(n=3101)的CKDII-V期为1.31(95%CI1.09至1.57),1.26(95%CI1.05至1.52),1.71(95%CI1.14至2.57),3.75(95%CI1.40至10.05),和4.96(95%CI1.56至15.75),分别。
结论:在新西兰T2DM患者中,CKD进展至各阶段(尤其是V期)的风险存在显著的种族差异.这些差异背后的机制研究,以及需要识别生物标志物来预测早期发作的肾脏病变,是有保证的。