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Proteinuria in South Asian children: prevalence and determinants

Tazeen H Jafar1, Nish Chaturvedi, Juanita Hatcher

  • 1Section of Nephrology, Department of Medicine, Aga Khan University, Stadium Road, PO Box 3500, Karachi, Pakistan. tazeen.jafar@aku.edu

Pediatric Nephrology (Berlin, Germany)
|June 11, 2005
PubMed

Insights

Proteinuria in Pakistani children varies significantly by ethnicity, suggesting early life factors, not just later-life conditions like diabetes, influence kidney disease risk. This highlights ethnic predispositions to proteinuria in South Asian youth.

Area of Science:

  • Pediatrics
  • Nephrology
  • Public Health

Background:

  • Proteinuria in children is a significant indicator of kidney disease and atherosclerosis, known predictors of cardiovascular mortality.
  • South Asian populations in Western countries may face a higher risk of kidney disease compared to native Caucasians.
  • Ethnic variations in proteinuria prevalence observed in adults in Pakistan warrant investigation in children to understand early-life determinants.

Purpose of the Study:

  • To explore the determinants of proteinuria in South Asian children.
  • To investigate whether ethnic predisposition to proteinuria manifests in childhood or develops later in life.
  • To analyze the association between ethnicity, socioeconomic status, dwelling, height, and proteinuria in Pakistani children.

Main Methods:

  • Analysis of a subset of data from the National Health Survey of Pakistan (1990-1994) involving 4977 children aged 5 to 14 years.
  • Proteinuria was identified using dipstick tests on random urine samples.
  • Ethnicity was categorized by mother-tongue into five major Pakistani subgroups: Muhajir, Punjabi, Sindhi, Pashtun, and Baluchi.

Main Results:

  • The overall prevalence of proteinuria was 3.3%, with significant ethnic variations: Sindhis (6.2%), Muhajirs (3.6%), Punjabis (2.8%), Baluchis (2.8%), and Pashtuns (1.0%) (p<0.001).
  • Multivariable analysis revealed proteinuria was associated with greater height (p=0.007), urban dwelling (p=0.03), lower socioeconomic status (p=0.02), and specific ethnicities (p=0.005).
  • The observed ethnic variation in childhood proteinuria mirrors that found in adults, suggesting early-life susceptibility.

Conclusions:

  • Ethnic variations in proteinuria among Pakistani children suggest inherent susceptibility or early exposure to kidney disease factors.
  • The findings indicate that ethnic predispositions to proteinuria appear in childhood, rather than solely developing from long-term undiagnosed conditions like diabetes or hypertension.
  • Further research is essential to identify specific early-life factors contributing to differential ethnic susceptibility to proteinuria and chronic kidney disease.

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