Socioeconomic Status and Chronic Kidney Disease Among Black and White Adults: An Analysis of 2017-2020 NHANES.

IF 3.4 Q1 UROLOGY & NEPHROLOGY
Kidney Medicine Pub Date : 2025-06-16 eCollection Date: 2025-08-01 DOI:10.1016/j.xkme.2025.101045
Benjamin Grobman, Ruth-Alma Turkson-Ocran, Mingyu Zhang, Stephen P Juraschek
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引用次数: 0

Abstract

Rationale & objective: Chronic kidney disease (CKD) disproportionately affects Black adults and those with lower socioeconomic status in the United States. The aim of this study was to examine the associations between socioeconomic status and CKD, albuminuria/stage 1-2 CKD, and stage 3-5 CKD, and to assess differences between Black and White adults.

Study design: We used data from the 2017-2020 National Health and Nutrition Examination Survey. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/1.73 m2 based on the race-free CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration) equation (stage 3-5 CKD) and/or a urinary albumin-creatinine ratio of >30 mg/g (albuminuria/stage 1-2 CKD).

Setting & participants: Respondents to the 2017-2020 National Health and Nutrition Examination Survey with Black or White race.

Exposure: Measures of socioeconomic status (income to poverty ratio, insurance status, education, employment status, and health care access).

Analytical approach: We examined the relationship between measures of socioeconomic status and CKD, albuminuria/stage 1-2 CKD, and stage 3-5 CKD using survey-weighted Poisson regressions controlling for age, sex, and medical comorbid conditions.

Results: The weighted sample (N = 182,622,525) was 52.2% women and 15.5% Black, with a mean age of 49.1 years. The prevalence of CKD was 15.6% in the overall sample, 20.9% among Black adults, and 14.7% among White adults. Higher income, higher education levels, and having health insurance were associated with a lower prevalence of CKD in the overall sample and among White adults, but not among Black adults. This pattern was consistent for those with albuminuria/stage 1-2 CKD, but not for those with stage 3-5 CKD.

Limitations: This study is limited by its cross-sectional design. In addition, data were based on single measurements and thus may be less precise in estimating the prevalence of chronic disease.

Conclusions: Higher socioeconomic status was inversely associated with albuminuria/stage 1-2 CKD and CKD among White but not Black adults. Future work should investigate the mechanisms by which albuminuria/stage 1-2 CKD remains independent of socioeconomic status among Black adults.

黑人和白人成年人的社会经济地位与慢性肾脏疾病:2017-2020年NHANES分析
理由与目的:在美国,慢性肾脏疾病(CKD)不成比例地影响黑人成年人和社会经济地位较低的人。本研究的目的是研究社会经济地位与CKD、蛋白尿/ 1-2期CKD和3-5期CKD之间的关系,并评估黑人和白人成年人之间的差异。研究设计:我们使用的数据来自2017-2020年全国健康与营养检查调查。根据无种族CKD- epi(慢性肾脏疾病流行病学协作)公式(3-5期CKD)和/或尿白蛋白-肌酐比值bbb30 mg/g(蛋白尿/ 1-2期CKD), CKD被定义为肾小球滤过率为2。背景和参与者:2017-2020年全国健康与营养调查的黑人或白人受访者。暴露:衡量社会经济地位(收入与贫困比率、保险状况、教育、就业状况和获得保健服务)。分析方法:我们使用调查加权泊松回归分析了社会经济地位与CKD、蛋白尿/ 1-2期CKD和3-5期CKD之间的关系,控制了年龄、性别和医疗合并症。结果:加权样本(N = 182,622,525)中女性占52.2%,黑人占15.5%,平均年龄49.1岁。总体样本中CKD患病率为15.6%,黑人成人患病率为20.9%,白人成人患病率为14.7%。较高的收入、较高的教育水平和拥有健康保险与总体样本和白人成年人中较低的CKD患病率相关,但在黑人成年人中没有。这种模式在蛋白尿/ 1-2期CKD患者中是一致的,但在3-5期CKD患者中则不一致。局限性:本研究受限于其横断面设计。此外,数据是基于单一测量,因此在估计慢性病流行率方面可能不太精确。结论:在白人成人中,较高的社会经济地位与蛋白尿/ 1-2期CKD和CKD呈负相关,而非黑人。未来的工作应该研究蛋白尿/ 1-2期CKD在黑人成年人中独立于社会经济地位的机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Kidney Medicine
Kidney Medicine Medicine-Internal Medicine
CiteScore
4.80
自引率
5.10%
发文量
176
审稿时长
12 weeks
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