Date of Conferral

2023

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Ndetan Harrison

Abstract

There are increasing concerns about the incorporation of race in the estimated glomerular filtration rate (eGFR) prediction equation. which has been used to measure renal function in studies that have shown a relationship between therapeutic dose of acetaminophen and light-moderate alcohol use to incipient renal insufficiency. The purpose of this study was to assess the same relationship, using a redefinition of renal insufficiency based on the chronic kidney disease–epidemiology collaboration creatinine-based eGFR, with and without race, and exploring the potential impact of race in the hypothesized relationship. Data from the 2003-2004 National Health and Nutrition Examination Survey were analyzed using multi-variable logistic regression. Results, after adjusting for hypertension, diabetes, and obesity, showed a statistically significant association of therapeutic dose of acetaminophen and light–moderate alcohol to incipient renal insufficiency, regardless of whether the eGFR prediction equation included race, OR = 2.65, 95% CI [1.74, 4.09], or did not include race, OR = 2.43, 95% CI [1.88, 3.14]. Thus, the hypothesized relationship of therapeutic dose of acetaminophen of light to moderate amount of alcohol to incipient renal insufficiency is ordered-preserved. Therefore, future largescale epidemiological studies to further investigate this issue are warranted. Implications for social change include designing awareness messages that target all racial groups about the effect on the kidneys of light drinking with a therapeutic dose of acetaminophen. With more awareness, individuals may be able to adjust their behavior to prevent kidney damage.

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