在一个种族和社会经济多样化的城市人口中，贫困、种族与慢性肾脏病。
Poverty, race, and CKD in a racially and socioeconomically diverse urban population.
机构信息
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
出版信息
Am J Kidney Dis. 2010 Jun;55(6):992-1000. doi: 10.1053/j.ajkd.2009.12.032. Epub 2010 Mar 6.
BACKGROUND
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.
STUDY DESIGN
Cross-sectional study.
SETTING & PARTICIPANTS: 2,375 community-dwelling adults aged 30-64 years residing within 12 neighborhoods selected for both socioeconomic and racial diversity in Baltimore City, MD.
PREDICTORS
Low SES (self-reported household income <125% of 2004 Department of Health and Human Services guideline), higher SES (> or =125% of guideline); white and African American race.
OUTCOMES & MEASUREMENTS: CKD defined as estimated glomerular filtration rate <60 mL/min/1.73 m(2). Logistic regression used to calculate ORs for relationship between poverty and CKD, stratified by race.
RESULTS
Of 2,375 participants, 955 were white (347 low SES and 608 higher SES) and 1,420 were African American (713 low SES and 707 higher SES). 146 (6.2%) participants had CKD. Overall, race was not associated with CKD (OR, 1.05; 95% CI, 0.57-1.96); however, African Americans had a much greater odds of advanced CKD (estimated glomerular filtration rate <30 mL/min/1.73 m(2)). 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, stratified by race, low SES was associated with CKD in African Americans (OR, 1.91; 95% CI, 1.54-2.38), but not whites (OR, 0.95; 95% CI, 0.58-1.55; P for interaction = 0.003).
LIMITATIONS
Cross-sectional design; findings may not be generalizable to non-urban populations.
CONCLUSIONS
Low SES has a profound relationship with CKD in African Americans, but not whites, in an urban population of adults, and its role in the racial disparities seen in CKD is worthy of further investigation.
背景
低社会经济地位（SES）和非裔美国人的种族都与终末期肾脏疾病和慢性肾脏病（CKD）的进展独立相关。然而，尽管它们经常同时发生，但低 SES 对 CKD 的影响在种族之外尚未得到很好的研究。
研究设计
横断面研究。
研究地点和参与者
2375 名居住在马里兰州巴尔的摩市 12 个社区的 30-64 岁的社区居民，这些社区在社会经济和种族方面都具有多样性。
预测因素
低 SES（自我报告的家庭收入<2004 年卫生与公众服务部指南的 125%）；高 SES（≥125%的指南）；白人和非裔美国人的种族。
结果
在 2375 名参与者中，955 名是白人（347 名低 SES 和 608 名高 SES），1420 名是非裔美国人（713 名低 SES 和 707 名高 SES）。146 名（6.2%）参与者患有 CKD。总体而言，种族与 CKD 无关（OR，1.05；95%CI，0.57-1.96）；然而，非裔美国人患有更严重的 CKD（估算肾小球滤过率<30 mL/min/1.73 m(2)）的几率要大得多。在调整了人口统计学、保险状况和合并症后，低 SES 与 CKD 风险增加 59%独立相关（OR，1.59；95%CI，1.27-1.99）。然而，按种族分层，低 SES 与非裔美国人 CKD 相关（OR，1.91；95%CI，1.54-2.38），而与白人无关（OR，0.95；95%CI，0.58-1.55；P 交互=0.003）。
局限性
横断面设计；研究结果可能不适用于非城市人群。
结论
在一个城市成年人的人群中，低 SES 与非裔美国人的 CKD 有深远的关系，但与白人无关，其在 CKD 种族差异中的作用值得进一步研究。
Zotero 插件