| Title: |
Socioeconomic status and risk of kidney dysfunction: The Atherosclerosis Risk in Communities study |
| Authors: |
Vart, P; Grams, ME; Ballew, SH; Woodward, M; Coresh, J; Matsushita, K |
| Source: |
urn:ISSN:0931-0509 ; urn:ISSN:1460-2385 ; Nephrology Dialysis Transplantation, 34, 8, 1361-1368 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2019 |
| Collection: |
UNSW Sydney (The University of New South Wales): UNSWorks |
| Subject Terms: |
32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Health Disparities and Racial or Ethnic Minority Health Research; Atherosclerosis; Basic Behavioral and Social Science; Women's Health; Kidney Disease; Behavioral and Social Science; Aging; Health Disparities; Renal and urogenital; Aged; Disease Progression; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Kidney Failure; Chronic; Male; Middle Aged; Poverty; Proportional Hazards Models; Prospective Studies; Residence Characteristics; Risk Factors; Social Class; chronic kidney disease; socioeconomic status; anzsrc-for: 32 Biomedical and Clinical Sciences |
| Description: |
Background: There is strong evidence of an association between socioeconomic status (SES) and end-stage renal disease (ESRD). However, the association of SES with the risk of chronic kidney disease (CKD) and the rate of change in kidney function is unclear. Methods: A cohort of 14 086 participants with an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m 2 at baseline in the Atherosclerosis Risk in Communities study (1987-89) were studied. The association of annual household income, educational attainment and neighborhood deprivation with incident ESRD, incident CKD and change in eGFR using four measurements over ∼23 years was assessed. Results: A total of 432 participants developed ESRD and 3510 developed CKD over a median follow-up time of ∼23 years. After adjustment for demographics and baseline eGFR, the hazard ratio (HR) for incident ESRD compared with the high-income group was 1.56 [95% confidence interval (CI) 1.22-1.99 in the medium-income group and 2.30 (95% CI 1.75-3.02) in the low-income group (P-trend < 0.001), and for CKD was 1.10 (95% CI 1.01-1.20) in the medium-income group and 1.30 (95% CI 1.17-1.44) in the low-income group (P-trend < 0.001). After full adjustments, the HR for ESRD was 1.33 (95% CI 1.03-1.70) in the medium-income group and 1.50 (95% CI 1.14-1.98) in the low-income group (P-trend = 0.003) and for CKD was 1.01 (95% CI 0.92-1.10) in the medium-income group and 1.04 (95% CI 0.93-1.16) in the low-income group (P-trend = 0.50). The eGFR decline was 5% and 15% steeper in the medium-and low-income groups, respectively, after full adjustment (P-trend < 0.001). Results were similar, with lower educational attainment and higher neighborhood deprivation being associated with adverse outcomes. Conclusions: SES (annual household income, educational attainment or neighborhood deprivation) was associated not only with ESRD risk but also with eGFR decline, although the association with CKD appeared weaker. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
unknown |
| Relation: |
https://hdl.handle.net/1959.4/unsworks_67060; https://doi.org/10.1093/ndt/gfy142 |
| DOI: |
10.1093/ndt/gfy142 |
| Availability: |
https://hdl.handle.net/1959.4/unsworks_67060; https://unsworks.unsw.edu.au/bitstreams/f31c3181-62e1-4c9d-a246-05393128e73d/download; https://doi.org/10.1093/ndt/gfy142 |
| Rights: |
open access ; https://purl.org/coar/access_right/c_abf2 ; CC-BY-NC-ND ; https://creativecommons.org/licenses/by-nc-nd/4.0/ ; free_to_read |
| Accession Number: |
edsbas.82450583 |
| Database: |
BASE |