Fored C Michael, Ejerblad Elisabeth, Fryzek Jon P, Lambe Mats, Lindblad Per, Nyrén Olof, Elinder Carl-Gustaf
Department of Medical Epidemiology, Karolinska Institutet, Stockholm, Sweden.
Nephrol Dial Transplant. 2003 Jan;18(1):82-8. doi: 10.1093/ndt/18.1.82.
Low socio-economic status is associated with the occurrence of several different chronic diseases, but evidence regarding renal disease is scant. To explore whether the risk of chronic renal failure varies by socio-economic status, we performed a population-based case-control study in Sweden.
All native residents from May 1996 to May 1998, aged 18-74 years, formed the source population. Cases (n = 926) were incident patients with chronic renal failure in a pre-uraemic stage. Control subjects (n = 998) were randomly selected within the source population. Exposures were assessed at personal interviews and relative risks were estimated by odds ratios (OR) in logistic regression models, with adjustment for age, sex, body mass index (BMI), smoking, alcohol consumption and regular analgesics use.
In families with unskilled workers only, the risk of chronic renal failure was increased by 110% [OR = 2.1; 95% confidence interval (CI), 1.1-4.0] and 60% (OR = 1.6; 95% CI, 1.0-2.6) among women and men, respectively, relative to subjects living in families in which at least one member was a professional. Subjects with 9 years or less of schooling had a 30% (OR = 1.3; 95% CI, 1.0-1.7) higher risk compared with those with a university education. The excess risk was of similar magnitude regardless of underlying renal disease.
Low socio-economic status is associated with an increased risk of chronic renal failure. The moderate excess was not explained by age, sex, BMI, smoking, alcohol or analgesic intake. Thus, socio-economic status appears to be an independent risk indicator for chronic renal failure in Sweden.
社会经济地位低下与多种不同慢性疾病的发生相关，但关于肾脏疾病的证据却很少。为探究慢性肾衰竭风险是否因社会经济地位而异，我们在瑞典开展了一项基于人群的病例对照研究。
1996年5月至1998年5月期间，年龄在18 - 74岁的所有瑞典本土居民构成了源人群。病例组（n = 926）为处于尿毒症前期的慢性肾衰竭新发病例。对照组（n = 998）是从源人群中随机选取的。通过个人访谈评估暴露因素，并在逻辑回归模型中用比值比（OR）估计相对风险，同时对年龄、性别、体重指数（BMI）、吸烟、饮酒和常规镇痛药使用情况进行调整。
仅由非技术工人组成的家庭中，相对于至少有一名家庭成员是专业人员的家庭中的受试者，女性和男性慢性肾衰竭风险分别增加了110% [OR = 2.1；95%置信区间（CI），1.1 - 4.0]和60%（OR = 1.6；95% CI，1.0 - 2.6）。受教育年限为9年或更少的受试者与大学学历者相比，风险高30%（OR = 1.3；95% CI，1.0 - 1.7）。无论潜在的肾脏疾病如何，额外风险的幅度相似。
社会经济地位低下与慢性肾衰竭风险增加相关。年龄、性别、BMI、吸烟、饮酒或镇痛药摄入并不能解释这种适度增加的风险。因此，在瑞典，社会经济地位似乎是慢性肾衰竭的一个独立风险指标。
