Abstract：
Insights into ethnic differences in the natural history of chronic kidney disease (CKD) among people with type 2 diabetes mellitus (T2DM) might inform clinical strategies to address disparities in hospitalization and mortality. Risks of CKD II-V stages over a 25-year period between New Zealand Europeans (NZEs), Māori and Pasifika, and with T2DM in Auckland, New Zealand (NZ) were compared.
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.
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.
摘要：
背景：对2型糖尿病（T2DM）患者中慢性肾脏病（CKD）自然史的种族差异的认识可能为解决住院和死亡率差异的临床策略提供依据。新西兰欧洲人(NZE)在25年期间CKDII-V阶段的风险，毛利人和帕西菲卡，奥克兰的T2DM，新西兰（NZ）进行了比较。
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。
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。
