Fraser Simon D S, Roderick Paul J, Aitken Grant, Roth Marilyn, Mindell Jennifer S, Moon Graham, O'Donoghue Donal
Academic Unit of Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, South Academic Block, Southampton General Hospital, Tremona Road, Southampton, Hampshire SO16 6YD, UK.
Geography and Environment, University of Southampton, Highfield, Southampton SO17 1BJ, UK.
J Public Health (Oxf). 2014 Dec;36(4):577-86. doi: 10.1093/pubmed/fdt117. Epub 2013 Nov 25.
Renal replacement therapy rates are inversely related to socioeconomic status (SES) in developed countries. The relationship between chronic kidney disease (CKD) and SES is less clear. This study examined the relationships between SES and CKD and albuminuria in England.
Data from the Health Survey for England 2009 and 2010 were combined. The prevalence of CKD 3-5 and albuminuria was calculated, and logistic regression used to determine their association with five individual-level measures and one area-level measure of SES.
The prevalence of CKD 3-5 was 5.2% and albuminuria 8.0%. Age-sex-adjusted CKD 3-5 was associated with lack of qualifications [odds ratio (OR) 2.27 (95% confidence interval 1.40-3.69)], low income [OR 1.50 (1.02-2.21)] and renting tenure [OR 1.36 (1.01-1.84)]. Only tenure remained significant in fully adjusted models suggesting that co-variables were on the causal pathway. Albuminuria remained associated with several SES measures on full adjustment: low income [OR 1.55 (1.14-2.11)], no vehicle [OR 1.38 (1.05-1.81)], renting [OR 1.31 [1.03-1.67)] and most deprived area-level quintile [OR 1.55 (1.07-2.25)].
CKD 3-5 and albuminuria were associated with low SES using several measures. For albuminuria this was not explained by known measured causal factors.
在发达国家,肾脏替代治疗率与社会经济地位(SES)呈负相关。慢性肾脏病(CKD)与SES之间的关系尚不清楚。本研究调查了英格兰地区SES与CKD及蛋白尿之间的关系。
合并2009年和2010年英格兰健康调查的数据。计算CKD 3 - 5期和蛋白尿的患病率,并采用逻辑回归分析确定它们与五项个体水平指标和一项地区水平SES指标之间的关联。
CKD 3 - 5期的患病率为5.2%,蛋白尿的患病率为8.0%。经年龄 - 性别调整后,CKD 3 - 5期与缺乏学历[比值比(OR)2.27(95%置信区间1.40 - 3.69)]、低收入[OR 1.50(1.02 - 2.21)]和租房居住[OR 1.36(1.01 - 1.84)]相关。在完全调整模型中,只有居住情况仍具有显著性,这表明协变量处于因果路径上。在完全调整后,蛋白尿仍与多项SES指标相关:低收入[OR 1.55(1.14 - 2.11)]、没有车辆[OR 1.38(1.05 - 1.81)]、租房[OR 1.31(1.03 - 1.67)]以及最贫困地区五分位数[OR 1.55(1.07 - 2.25)]。
采用多种指标衡量时,CKD 3 - 5期和蛋白尿与低SES相关。对于蛋白尿而言,已知的测量因果因素无法解释这种关联。