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ABSTRACT: Objective
To examine the association between income level and incident chronic kidney disease (CKD) in adults with normal baseline kidney function.Patient and methods
We studied the association between income level categorized into deciles and incident CKD in a national cohort comprised of 7,405,715 adults who underwent National Health Insurance Service health examinations during January 1, 2009, to December 31, 2015, with baseline estimated glomerular filtration rates (eGFRs) ?60 mL/min/1.73 m2. Incident CKD was defined as de novo development of eGFR <60 mL/min/1.73 m2 (model 1) or ?25% decline in eGFR from baseline values accompanied by eGFR <60 mL/min/1.73 m2 (model 2).Results
During a median follow-up of 4.8 years, there were 122,032 of 7,405,715 (1.65%) and 55,779 of 7,405,715 (0.75%) incident CKD events based on model 1 and 2 definitions, respectively. Compared with income levels in the sixth decile, there was an inverse association between lower income level and higher risk for CKD up to the fourth decile, above which no additional reduction (model 1) or slightly higher risk for CKD (model 2) was observed at higher income levels. The multivariable-adjusted hazard ratios from the lowest to fourth deciles were 1.30 (95% CI, 1.26-1.33), 1.16 (95% CI, 1.13-1.19), 1.07 (95% CI, 1.05-1.10), and 1.06 (95% CI, 1.03-1.09) in model 1 and 1.32 (95% CI, 1.27-1.37), 1.18 (95% CI, 1.14-1.22), 1.08 (95% CI, 1.04-1.13), and 1.05 (95% CI, 1.01-1.09) in model 2, respectively. These associations persisted across various subgroups of age, sex, and comorbidity status.Conclusion
In this large nationwide cohort, lower income levels were associated with higher risk for incident CKD.
SUBMITTER: Chang TI
PROVIDER: S-EPMC7224965 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
Chang Tae Ik TI Lim Hyunsun H Park Cheol Ho CH Rhee Connie M CM Kalantar-Zadeh Kamyar K Kang Ea Wha EW Kang Shin-Wook SW Han Seung Hyeok SH
Mayo Clinic proceedings 20200201 2
<h4>Objective</h4>To examine the association between income level and incident chronic kidney disease (CKD) in adults with normal baseline kidney function.<h4>Patient and methods</h4>We studied the association between income level categorized into deciles and incident CKD in a national cohort comprised of 7,405,715 adults who underwent National Health Insurance Service health examinations during January 1, 2009, to December 31, 2015, with baseline estimated glomerular filtration rates (eGFRs) ≥6 ...[more]