Objective
Perceived discrimination has been associated with psychosocial distress and adverse health outcomes. We examined associations of perceived discrimination measures with changes in kidney function in a prospective cohort study, the Healthy Aging in Neighborhoods of Diversity Across the LifeSpan.
Methods
Our study included 1,620 participants with preserved baseline kidney function (estimated glomerular filtration rate (eGFR) ≥60 ml/min/1.73m2) (662 Whites and 958 African-Americans (AA), aged 30–64 years). Self-reported perceived racial discrimination (PRD) and perceived gender discrimination (PGD) and a general measure of experience of discrimination (EOD) [“Medium vs. low”, “High vs. low”] were examined in relation to baseline, follow-up and annual rate of change in eGFR using multiple mixed-effects regression (γbase, γrate) and OLS models (γfollow).
Results
Perceived gender discrimination “High vs. Low PGD” was associated with a lower baseline eGFR in all models (γbase=−3.51(1.34), p=0.009 for total sample). Among White women, High EOD was associated with lower baseline eGFR, an effect that was strengthened in the full model (γbase=−5.86(2.52), p=0.020). Overall, “High vs. Low” PGD was associated with lower follow-up eGFR (γfollow=−3.03(1.45), p=0.036). Among AA women, both PRD and PGD were linked to lower follow-up kidney function, an effect that was attenuated with covariate adjustment, indicating mediation through health-related, psychosocial and lifestyle factors. In contrast, EOD was not linked to follow-up eGFR in any of the sex by race groups.
Conclusions
Perceived racial and gender discrimination are associated with poor kidney function assessed by glomerular filtration rate and the strength of associations differ by sex and race groups. Perceived discrimination deserves further investigation in psychsocial risk factors for kidney disease.