Tentori Francesca, Stidley Christine A, Scavini Marina, Shah Vallabh O, Narva Andrew S, Paine Susan, Bobelu Arlene, Welty Thomas K, Maccluer Jean W, Zager Philip G
Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131-5241, USA.
Am J Kidney Dis. 2003 Jun;41(6):1195-204. doi: 10.1016/s0272-6386(03)00351-2.
There is an epidemic of kidney disease among the Zuni Indians. In contrast to other American Indian tribes, the epidemic among the Zuni Indians is attributable to diabetic and nondiabetic renal disease.
The Zuni Kidney Project, established to reduce the burden of renal disease, conducted a population-based cross-sectional survey of Zuni Indians aged 5 years or older to precisely estimate the prevalence of hematuria. The survey used neighborhood household clusters as the sampling frame to maximize ascertainment and minimize bias. During the survey, we administered a questionnaire; collected blood and urine samples; and measured blood pressure, height, and weight.
Age and sex distributions in our sample (n = 1,469) were similar to those of the eligible Zuni population (n = 9,228). Prevalences of hematuria, defined as dipstick of trace or greater and 50 red blood cells/microL or greater, age- and sex-adjusted to the Zuni population aged 5 years or older, were 33.2% (95% confidence interval [CI], 30.7 to 35.6) and 17.8% (95% CI, 15.8 to 19.8), respectively. Hematuria of trace or greater was more common among females (40.6%; 95% CI, 37.0 to 44.1) than males (25.1%; 95% CI, 21.8 to 28.4). Hematuria of trace or greater was common among Zuni Indians without diabetes (females, 39.7%; 95% CI, 35.7 to 43.8; males, 22.7%; 95% CI, 19.4 to 26.1) and with diabetes (females, 47.5%; 95% CI, 39.8 to 55.2; males, 45.8%; 95% CI, 34.3 to 57.3). Diabetes and alcohol use for greater than 10 years were associated with hematuria among males, but not females.
The prevalence of hematuria is high among Zuni Indians with and without diabetes. These findings are consistent with the hypothesis that nondiabetic kidney disease is common among Zuni Indians with and without diabetes.
祖尼印第安人当中存在肾病流行情况。与其他美洲印第安部落不同，祖尼印第安人的这种流行病归因于糖尿病性和非糖尿病性肾病。
为减轻肾病负担而设立的祖尼肾脏项目，对5岁及以上的祖尼印第安人进行了一项基于人群的横断面调查，以精确估计血尿的患病率。该调查以邻里家庭群为抽样框架，以最大限度地提高确诊率并减少偏差。在调查过程中，我们发放了问卷；采集了血液和尿液样本；并测量了血压、身高和体重。
我们样本（n = 1469）中的年龄和性别分布与符合条件的祖尼人群（n = 9228）相似。血尿的患病率，定义为试纸检测微量或更高且每微升有50个或更多红细胞，经年龄和性别调整至5岁及以上的祖尼人群，分别为33.2%（95%置信区间[CI]，30.7至35.6）和17.8%（95%CI，15.8至19.8）。微量或更高程度的血尿在女性中（40.6%；95%CI，37.0至44.1）比男性中（25.1%；95%CI，21.8至28.4）更为常见。微量或更高程度的血尿在无糖尿病的祖尼印第安人（女性，39.7%；95%CI，35.7至43.8；男性，22.7%；95%CI，19.4至26.1）和有糖尿病的祖尼印第安人（女性，47.5%；95%CI，39.8至55.2；男性，45.8%；95%CI，34.3至57.3）中都很常见。糖尿病和饮酒超过10年与男性的血尿有关，但与女性无关。
无论有无糖尿病，祖尼印第安人当中血尿的患病率都很高。这些发现与非糖尿病性肾病在有糖尿病和无糖尿病的祖尼印第安人当中都很常见这一假设一致。
