Prevalence of diabetic kidney disease by world region of birth among immigrants and long-term residents of Canada with type 2 diabetes

Aims — To measure the prevalence of diabetic kidney disease (DKD) among immigrants and long-term residents with type 2 diabetes (T2D).

Methods — We conducted a population-based retrospective cohort study in Ontario, Canada among adults aged 20–79 years with T2D. The exposure was world region of birth (immigrants); long-term residents were the comparison group. The outcome was DKD, defined by the Kidney Disease: Improving Global Outcomes (KDIGO) categories. We measured the age-sex standardized prevalence of DKD and constructed logistic regression models to compute adjusted odds ratios (OR) estimating the association between the exposure and outcome.

Results — We included 210,693 immigrants (mean age 59.8 [standard deviation 10.8] years, 54.3 % male) and 539,632 long-term residents (mean age 64.1 [10.4] years, 56.1 % male). Immigrants born in East Asia had the highest prevalence and adjusted odds of the KDIGO low-risk category (76.6 %, OR 1.59, 1.53–1.64). Immigrants born in Southeast Asia had the lowest prevalence of the KDIGO low-risk category (64.0 %), and the highest prevalence and adjusted odds of the moderately-increased, high, and very-high risk KDIGO categories (OR: 1.21, [1.18–1.25]; 1.20, 1.14–1.26; 1.18, 1.12–1.25) compared to long-term residents.

Conclusions — There is substantial variation in the prevalence of DKD among immigrants according to world region of birth.