Understanding the Link between Neighborhoods and Kidney Disease.
Understanding the Link between Neighborhoods and Kidney Disease.
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DOI：
10.34067/kid.0001202019
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发表时间：
2020-08
期刊：
影响因子：
--
通讯作者：
Hicken MT
中科院分区：
文献类型：
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作者：
Lapedis CJ;Mariani LH;Jang BJ;Hodgin J;Hicken MT
社区是我们生活、学习、工作、祈祷和玩耍的地方。越来越多的证据表明，邻里关系是健康的重要决定因素。我们社区的建筑特征，如街道设计和连接的方式，以及绿地和中转站的可用性，以及社会特征，如邻居之间的信任和安全感，可能会通过多个途径影响健康，如获得重要资源、心理社会压力和健康行为。特别是，现有的文献一致地记录了邻居特征和肾脏相关疾病之间的联系，如心血管疾病、高血压、糖尿病和肥胖症。也有一些证据表明，社区贫困和ESKD之间存在关联。然而，社区和CKD早期阶段之间的联系一直不太清楚，大多数研究都没有记录这种联系。这可能是因为以前研究中使用的邻里关系测量方法没有捕捉到邻里关系的特征，这些特征对于疾病发展和进展的早期阶段很重要。也可能是我们目前的生物标记物(例如，EGFR)和尿蛋白不能发现早期形式的肾脏损害，因为肾脏总体上具有很高的储备能力。本文对邻里关系与肾脏疾病的文献现状进行了批判性的回顾，并对未来研究中的邻里关系措施提出了建议。社区是由政策设计、建设和提供信息的，因此，它们容易受到干预，使它们成为改善肾脏健康和减少人口层面健康不平等的潜在有效方法。
Neighborhoods are where we live, learn, work, pray, and play. Growing evidence indicates that neighborhoods are an important determinant of health. The built features of our neighborhoods, such as the ways in which the streets are designed and connected and the availability of green spaces and transit stops, as well as the social features, such as the trust among neighbors and the perceptions of safety, may influence health through multiple pathways, such as access to important resources, psychosocial stress, and health behaviors. In particular, the extant literature consistently documents an association between neighborhood features and renal-associated conditions, such as cardiovascular disease, hypertension, diabetes, and obesity. There is also some evidence suggesting an association between neighborhood poverty and ESKD. The link between neighborhood and earlier stages of CKD, however, has been less clear, with most studies documenting no association. It may be that the neighborhood measures used in previous studies do not capture features of the neighborhood important for earlier stages of disease development and progression. It may also be that our current biomarkers (e.g., eGFR) and urine protein are not able to pick up very early forms of renal damage because of the kidney’s overall high reserve capacity. This paper critically reviews the state of the literature on neighborhood and renal disease, with recommendations for neighborhood measures in future research. Neighborhoods are designed, built, and informed by policy, and thus, they are amenable to intervention, making them a potentially powerful way to improve renal health and reduce health inequalities at the population level.