The Relationship Between Immigration Status and Chronic Kidney Disease Risk Factors in Immigrants and US-Born Adults

To understand the relationship between nativity and measures of kidney function including estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR). Seven waves of data from the National Health and Nutrition Examination Survey (2001-2014) was analyzed. General linear regression methods were used to assess the relationship between eGFR, ACR and nativity (foreign-born vs. US-born). Models were adjusted for length of time in the US, demographic variables, comorbidities, lifestyle factors, and access to healthcare. There were 27,111 individuals representing 217,842,257 US adults included in the study. Approximately 26.1% were immigrants, with 40.4% of immigrants having resided < 15 years in the US. Among immigrants with < 15 years of residence, 51% were Hispanic, and 54.4% had high school or below education. After controlling for demographics and length of time in the US, immigrants were 26% more likely to have an ACR ≥ 30 mg/g (OR 1.26, 95% CI: 1.08-1.47); however, after controlling for demographics, length of time, comorbidities, and lifestyle factors the results were no longer significant. Immigrants were significantly less likely to have an eGFR < 60 (OR 0.42, 95% CI 0.36-0.50), which remained after adjustment (OR 0.75, 95% CI 0.61-0.93). Immigrants had significantly lower odds of having an eGFR < 60 compared to US-born adults. Additionally, immigrants with ≥ 15 years in the US had mean eGFR values that were less than immigrants < 15 years in the US, indicating that there is some decrease in kidney function as the length of US residence increases.