Socioeconomic status and chronic kidney disease at presentation to a renal service in the United Kingdom
Socioeconomic status and chronic kidney disease at presentation to a renal service in the United Kingdom
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DOI：
10.2215/cjn.00680208
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发表时间：
2008-09-01
影响因子：
9.8
通讯作者：
El Nahas, Meguid
中科院分区：
文献类型：
--
作者：
Bello, Aminu K.;Peters, Jean;El Nahas, Meguid
背景和目标：低社会经济地位（SES）与慢性肾脏病（CKD）的发生和进展相关。 SES 对肾脏科就诊时 CKD 严重程度的影响尚不清楚。本研究对谢菲尔德肾脏研究所（英国谢菲尔德）的 1657 名患者进行回顾性横断面分析，调查了 SES 与 CKD 严重程度之间的关系。设计、设置、参与者和测量：根据居住选区的邮政编码将 SES 分配给每位患者，并根据相应的英国多重剥夺指数评分进行排名，该指数由五个剥夺五分位数组成 （Q1，最贫困；Q5. 最贫困）。使用国家肾脏基金会肾脏疾病结果质量倡议对 CKD 分类进行分层和分析。应用二元逻辑回归分析来分析变量/风险因素与就诊时 CKD（较低 GFR）的关联。结果：按居住地划分，在五个剥夺五分位数中，每百万人口中就诊时确诊 CKD 的年龄调整患病率是 Q1 = 1495、Q2 = 3530、Q3 = 3398、Q4 = 3989 和 Q5 = 19,599。 Logistic 回归模型显示，在调整社会人口统计学、生活方式和临床变量后，与最高 SES (Q1) 相比，生活在最低 SES 五分位数区域 (Q5) 与出现较低估计 GFR 的风险更大相关。结论：低 SES 与就诊时 CKD 的严重程度相关。需要进一步研究来检验英国各个社会经济地位类别中的这个问题。
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.