Low income, community poverty and risk of end stage renal disease

Details

Ressource 1Download: BIB_8E3F61F5A695.P001.pdf (326.60 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_8E3F61F5A695
Type
Article: article from journal or magazin.
Collection
Publications
Title
Low income, community poverty and risk of end stage renal disease
Journal
Bmc Nephrology
Author(s)
Crews D.C., Gutiérrez O.M., Fedewa S.A., Luthi J.C., Shoham D., Judd S.E., Powe N.R., McClellan W.M.
ISSN
1471-2369 (Electronic)
ISSN-L
1471-2369
Publication state
Published
Issued date
12/2014
Peer-reviewed
Oui
Volume
15
Number
1
Pages
192
Language
english
Notes
Publication types: Journal Article Publication Status: epublish
Abstract
BACKGROUND: The risk of end stage renal disease (ESRD) is increased among individuals with low income and in low income communities. However, few studies have examined the relation of both individual and community socioeconomic status (SES) with incident ESRD.
METHODS: Among 23,314 U.S. adults in the population-based Reasons for Geographic and Racial Differences in Stroke study, we assessed participant differences across geospatially-linked categories of county poverty [outlier poverty, extremely high poverty, very high poverty, high poverty, neither (reference), high affluence and outlier affluence]. Multivariable Cox proportional hazards models were used to examine associations of annual household income and geospatially-linked county poverty measures with incident ESRD, while accounting for death as a competing event using the Fine and Gray method.
RESULTS: There were 158 ESRD cases during follow-up. Incident ESRD rates were 178.8 per 100,000 person-years (105 py) in high poverty outlier counties and were 76.3 /105 py in affluent outlier counties, p trend = 0.06. In unadjusted competing risk models, persons residing in high poverty outlier counties had higher incidence of ESRD (which was not statistically significant) when compared to those persons residing in counties with neither high poverty nor affluence [hazard ratio (HR) 1.54, 95% Confidence Interval (CI) 0.75-3.20]. This association was markedly attenuated following adjustment for socio-demographic factors (age, sex, race, education, and income); HR 0.96, 95% CI 0.46-2.00. However, in the same adjusted model, income was independently associated with risk of ESRD [HR 3.75, 95% CI 1.62-8.64, comparing the < $20,000 income group to the > $75,000 group]. There were no statistically significant associations of county measures of poverty with incident ESRD, and no evidence of effect modification.
CONCLUSIONS: In contrast to annual family income, geospatially-linked measures of county poverty have little relation with risk of ESRD. Efforts to mitigate socioeconomic disparities in kidney disease may be best appropriated at the individual level.
Pubmed
Web of science
Open Access
Yes
Create date
22/12/2014 16:25
Last modification date
20/08/2019 14:52
Usage data