Poverty, race, and CKD in a racially and socioeconomically diverse urban population.
Poverty, race, and CKD in a racially and socioeconomically diverse urban population.
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DOI：
10.1053/j.ajkd.2009.12.032
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发表时间：
2010-06
期刊：
影响因子：
--
通讯作者：
Powe NR
中科院分区：
文献类型：
--
作者：
Crews DC;Charles RF;Evans MK;Zonderman AB;Powe NR
社会经济地位低（SES）和非裔美国人种族都分别与终末期肾病和进行性慢性肾脏病（CKD）相关，然而，尽管它们经常同时出现，但在慢性肾脏病中，独立于种族的社会经济地位低的影响尚未得到充分研究。
横断面研究。
2375名年龄在30 - 64岁之间的社区居住成年人，居住在马里兰州巴尔的摩市因社会经济和种族多样性而选取的12个社区内。
低社会经济地位[自我报告的家庭收入<2004年卫生与公众服务部指南的125%]，高社会经济地位（≥指南的125%）；白人和非裔美国人种族。
慢性肾脏病定义为估计肾小球滤过率（eGFR）<60 mL/min/1.73 m²。采用逻辑回归计算贫困与慢性肾脏病之间关系的比值比（OR），并按种族分层。
在2375名参与者中；955名是白人（347名社会经济地位低，608名社会经济地位高）；1420名是非裔美国人（713名社会经济地位低，707名社会经济地位高）。共有146名（6.2%）参与者患有慢性肾脏病。总体而言，种族与慢性肾脏病无关[比值比为1.05；95%置信区间（CI）为0.57 - 1.96]；然而，非裔美国人患晚期慢性肾脏病（eGFR <30 mL/min/1.73 m²）的几率要高得多。在对人口统计学特征、保险状况和合并疾病进行调整后，社会经济地位低与慢性肾脏病的患病几率增加59%独立相关（比值比为1.59；95%置信区间为1.27 - 1.99）。然而，按种族分层时，社会经济地位低与非裔美国人的慢性肾脏病相关（比值比为1.91；95%置信区间为1.54 - 2.38），但与白人无关（比值比为0.95；95%置信区间为0.58 - 1.55；交互作用的P值为0.003）。
横断面设计；研究结果可能无法推广到非城市人群。
在成年城市人群中，社会经济地位低与非裔美国人的慢性肾脏病有密切关系，但与白人无关，其在慢性肾脏病中种族差异方面的作用值得进一步研究。
Low socioeconomic status (SES) and African American race are both independently associated with end-stage renal disease and progressive chronic kidney disease (CKD), however, despite their frequent co-occurrence, the effect of low SES independent of race has not been well-studied in CKD. Cross-sectional study. 2,375 community-dwelling adults age 30-64 years residing within 12 neighborhoods selected for both socioeconomic and racial diversity in Baltimore City, Maryland. Low SES [self-reported household income <125% of 2004 Department of Health and Human Services guideline], higher SES (≥125% of guideline); white and African American race. CKD defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Logistic regression used to calculate odds ratios (OR) for relationship between poverty and CKD, stratified by race. Of 2,375 participants; 955 were white (347 low SES and 608 higher SES); 1,420 were African American (713 low SES and 707 higher SES). A total of 146 (6.2%) participants had CKD. Overall, race was not associated with CKD [OR, 1.05; 95% confidence interval (CI), 0.57-1.96]; however, African Americans had a much greater odds of advanced CKD (eGFR <30 mL/min/1.73 m2). Low SES was independently associated with 59% greater odds of CKD after adjustment for demographics, insurance status and comorbid disease (OR, 1.59; 95% CI, 1.27-1.99). However, when stratified by race, low SES was associated with CKD in African Americans (OR, 1.91; 95% CI, 1.54-2.38), but not in whites (OR, 0.95; 95% CI, 0.58-1.55; P for interaction, 0.003). Cross-sectional design; findings may not be generalizable to non-urban populations. Low SES has a profound relationship with CKD in African Americans but not in whites in an urban population of adults, and its role in the racial disparities seen in CKD is worthy of further investigation.
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