Risk Factors for Kidney Disease in Chinese Americans: Data From the Kidney Disease Screening and Awareness Program (KDSAP)

Abstract

Authors: Stephanie Lin and Li-Li Hsiao, M.D., Ph.D. Purpose: To characterize the Chinese-American population screened through the Kidney Disease Screening and Awareness Program (KDSAP) and identify risk factors for proteinuria. Methods: Cross-sectional data were collected through KDSAP screening sites in the United States (Massachusetts, New Jersey, and Maine) and Canada (Toronto) from 2011-2016. Data were collected in the form of surveys assessing demographics, medical history, and healthcare access as well as biometric measurements (body mass index, waist-hip-ratio, random finger-stick blood glucose, and blood pressure) and urinalysis. Risk factors for proteinuria were identified through multivariable logistic regression. Results: In total, 510 participants were screened, with a prevalence of proteinuria of 14.1%. 30% of the total screened population was uninsured, while among subjects found to have proteinuria, 22.2% were uninsured. Independent risk factors for proteinuria included untreated diabetes (OR 2.38, p<0.05), history of proteinuria (OR 2.76, p<0.01), and increased diastolic blood pressure (OR 1.05, p <0.01). Less frequent medical visits were negatively correlated with proteinuria (OR 0.22, p<0.05). Conclusions: The data demonstrate that KDSAP is identifying individuals with proteinuria in an at-risk population with higher-than-average uninsured rates. The typical risk factors for kidney disease previously identified in native Chinese and non-Asian populations such as age, gender, and cardiovascular disease were not statistically significant in this dataset, while untreated diabetes, history of proteinuria, and increased diastolic blood pressure were significant. Despite the sample size limitation, this study provides a preliminary analysis of a unique dataset from a population that has been understudied in the kidney disease literature.