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Proteinuria in South Asian children: prevalence and determinants

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Abstract

Proteinuria in children is a marker of kidney disease and atherosclerosis, both which are known predictors of cardiovascular mortality. Recent evidence suggests that migrant South Asian populations living in the West may be at higher risk of kidney disease than native Caucasians. However, the determinants of proteinuria in South Asian children have not been explored. Previously, we reported ethnic variation in the prevalence of proteinuria in the adult population of Pakistan. However, it is not known whether ethnic predisposition to proteinuria appears during childhood or whether it is acquired later in life as a result of prolonged exposure to undiagnosed diabetes and hypertension.

Analyses were based on a subset of data for 4977 children aged 5 to less than 15 years collected as part of the broad National Health Survey of Pakistan, conducted between 1990 and 1994. Proteinuria was defined as a dipstick positive for protein on a random urine sample. Ethnicity was reported as “mother-tongue”, which is specific for each of the five major ethnic subgroups of Pakistan: Muhajir, Punjabi, Sindhi, Pashtun, and Baluchi.

The overall prevalence (95% CI) of proteinuria in the children was 3.3% (2.7–3.9%). It was 6.2% in Sindhis, 3.6% in Muhajirs, 2.8% in Punjabis, 2.8% in Baluchis, and 1.0% in Pashtuns (p<0.001). In multivariable analyses, proteinuria was associated with greater height (p=0.007), urban dwelling (p=0.03), lower socioeconomic status (p=0.02), and certain ethnicities (p=0.005).

The ethnic variation in proteinuria in South Asian children mirrors variation among ethnic groups in adults. This suggests variations in susceptibility or early exposure to causes of chronic kidney disease, rather than long-term exposure to undiagnosed diabetes or hypertension. Further studies are needed to determine factors in early life that may differentially predispose certain ethnic groups to proteinuria.

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Authors and Affiliations

  1. Section of Nephrology, Department of Medicine, Aga Khan University, Stadium Road, PO Box 3500, Karachi, Pakistan

    Tazeen H. Jafar & Anas Rabbani

  2. Clinical Epidemiology Unit, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan

    Tazeen H. Jafar & Juanita Hatcher

  3. Division of Nephrology, Tufts-New England Medical Center, Department of Medicine, Tufts University School of Medicine, Boston, MA, USA

    Tazeen H. Jafar & Andrew S. Levey

  4. National Heart and Lung Institute, Imperial College of Medicine at St. Mary’s, London, UK

    Nish Chaturvedi

  5. Department of Pediatrics, Aga Khan University, Karachi, Pakistan

    Iqtidar Khan

  6. Pakistan Medical Research Council, Islamabad, Pakistan

    Abdul Qayum Khan

  7. Division of Pediatric Nephrology, University of Texas at Houston, Houston, TX, USA

    Ronald Portman

  8. Division of Clinical Care Research, Tufts-New England Medical Center, Department of Medicine, Tufts University School of Medicine School, Boston, MA, USA

    Christopher H. Schmid

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  1. Tazeen H. Jafar
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  6. Abdul Qayum Khan
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  7. Ronald Portman
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  8. Christopher H. Schmid
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  9. Andrew S. Levey
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Correspondence to Tazeen H. Jafar.

Additional information

Supported by grants from Fogarty International Center, NIH RO3 TWO5657–01A1 (Drs. Levey/Jafar//Schmid/Chaturvedi), and NIDDK RO1 DK53869 (Dr. Levey)

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Jafar, T.H., Chaturvedi, N., Hatcher, J. et al. Proteinuria in South Asian children: prevalence and determinants. Pediatr Nephrol 20, 1458–1465 (2005). https://doi.org/10.1007/s00467-005-1923-8

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  • DOI: https://doi.org/10.1007/s00467-005-1923-8

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