Socioeconomic Status and Chronic Kidney Disease at Presentation to a Renal Service in the United Kingdom

Abstract

Background and objectives: Low socioeconomic status (SES) is associated with both development and progression of chronic kidney disease (CKD). The impact of SES on severity of CKD at presentation to a renal service is less well known. This study investigated the relationship between SES and severity of CKD in a retrospective, cross-sectional analysis involving 1657 patients at the Sheffield Kidney Institute (Sheffield, UK).Design, setting, participants, & measurements: SES was assigned to each patient according to electoral ward of residence by postcode and ranked according to the corresponding British Index of Multiple Deprivation score, which comprises five deprivation quintiles (Q1, least deprived; Q5, most deprived). National Kidney Foundation Kidney Disease Outcomes Quality Initiative classification of CKD was used for stratification and analysis. Binary logistic regression analysis was applied for the association of variables/risk factors with CKD (lower GFR) at presentation.Results: The age-adjusted prevalence of diagnosed CKD at presentation by area of residence, across the five deprivation quintiles, per million population was Q1 ‫؍‬ 1495, Q2 ‫؍‬ 3530, Q3 ‫؍‬ 3398, Q4 ‫؍‬ 3989, and Q5 ‫؍‬ 19,599. Logistic regression models showed that living in the lowest SES quintile area (Q5) as compared with the highest SES (Q1) was associated with a greater risk for presenting with a lower estimated GFR, after adjustment for sociodemographic, lifestyle, and clinical variables.Conclusions: Low SES is related to severity of CKD at presentation. Further studies are needed to examine this issue across the various SES categories in the United Kingdom.

Chronic kidney disease, albuminuria and socioeconomic status in the Health Surveys for England 2009 and 2010

“…21 Cross-sectional data from the Whitehall II cohort identified higher odds of low eGFR in lower occupational grades; this association was attenuated after adjustment for BMI and components of the metabolic syndrome; similar to our findings. 30 The Atherosclerosis Risk in Communities (ARIC) study identified an association of CKD incidence with individual SES (occupation).…”

“…17,18 Data from NHANES III demonstrated the association between microalbuminuria and poverty, 19 but no evidence is available in the UK on the relationship between albuminuria and SES. The association between low SES and increased risk of CKD diagnosis 20 and increased severity of CKD at presentation to renal services 21 has been demonstrated in the UK. Any observed variations in the CKD prevalence may be explained by differences in lifecourse exposures harmful to the kidney, such as foetal environment, environmental toxins, tobacco, obesity, hypertension and diabetes; and access to and use of health services.…”

End-Stage Renal Disease in the Gaza Strip and Its Relationship to Risk Factors

“…Another study agrees this statement, for example, Ward, performed studies to examine the association between socioeconomic status with increased risk of ESRD due to diabetes and access to care in California, reported that there is a strong association between the incidence of ESRD related to diabetes and access to care [25]. Other studies confirm that positive relation between living in low socioeconomic status and severity of chronic renal disease [17,26]. This study found statistical significant association between occupation, primary educational level, low income, and citizenship subjects tended to have significantly higher end-stage renal disease prevalence.…”

Screening for risk factors of chronic kidney disease in a community in Niger Delta Nigeria

“…[10] This pattern has been reported to increase the risk for development and propagation of CKD. [11] This entails by virtue of this sociodemographic pattern, this community is at a high-risk of CKD. This contrasts with the sociodemographic pattern of most developed countries of USA and Europe which could explain the reported lower prevalence of CKD in these populations.…”