Poverty and racial disparities in kidney disease: the REGARDS study.

Academic Article

Abstract

  • UNLABELLED: There are pronounced disparities among black compared to white Americans for risk of end-stage renal disease. This study examines whether similar relationships exist between poverty and racial disparities in chronic kidney disease (CKD) prevalence. METHODS: We studied 22,538 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. We defined individual poverty as family income below USD 15,000 and a neighborhood as poor if 25% or more of the households were below the federal poverty level. RESULTS: As the estimated glomerular filtration rate (GFR) declined from 50-59 to 10-19 ml/min/ 1.73 m2, the black:white odds ratio (OR) for impaired kidney function increased from 0.74 (95% CI 0.66, 0.84) to 2.96 (95% CI 1.96, 5.57). Controlling for individual income below poverty, community poverty, demographic and comorbid characteristics attenuated the black:white prevalence to an OR of 0.65 (95% CI 0.57, 0.74) among individuals with a GFR of 59-50 ml/min/1.73 m2 and an OR of 2.21 (95% CI 1.25, 3.93) among individuals with a GFR between 10 and 19 ml/min/ 1.73 m2. CONCLUSION: Household, but not community poverty, was independently associated with CKD and attenuated but did not fully account for differences in CKD prevalence between whites and blacks.
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    Keywords

  • African Americans, Aged, Aged, 80 and over, Comorbidity, Creatinine, European Continental Ancestry Group, Female, Glomerular Filtration Rate, Humans, Income, Male, Middle Aged, Poverty, Prevalence, Renal Insufficiency, Chronic, Risk Factors, Severity of Illness Index
  • Digital Object Identifier (doi)

    Author List

  • McClellan WM; Newsome BB; McClure LA; Howard G; Volkova N; Audhya P; Warnock DG
  • Start Page

  • 38
  • End Page

  • 46
  • Volume

  • 32
  • Issue

  • 1