Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, Australia.
Sydney School of Public Health, The University of Sydney, Sydney, Australia.
Pediatr Nephrol. 2022 Dec;37(12):3195-3204. doi: 10.1007/s00467-022-05515-3. Epub 2022 Mar 30.
Lower socioeconomic status (SES) is associated with lower academic achievement; however, this relationship is understudied in children with chronic kidney disease (CKD). This study examined the relationship between SES and academic performance in children and adolescents with CKD.
A total of 377 participants aged 6-18 years with CKD stages 1-5 (n = 199), on dialysis (n = 43) or with a kidney transplant (n = 135) were recruited. Five SES measures and a composite SES index were examined for associations with parent-rated average or above average academic performance in numeracy and literacy using multivariable logistic regression.
Participants' median age was 12.6 years (IQR 8.9-15.5). Adjusted odds ratios (aOR) (95%CI) for better performance in numeracy and literacy, respectively, were 0.71 (0.44-1.15) and 0.75 (0.45-1.23) for children whose caregivers had lower educational attainment; 0.46 (0.26-0.80) and 0.53 (0.30-0.93) for lower household income; 0.52 (0.32-0.85) and 0.44 (0.26-0.73) for caregivers who were unemployed; 0.68 (0.41-1.12) and 0.59 (0.35-1.00) for caregivers with poor self-rated financial status; and 0.93 (0.53-1.64) and 1.00 (0.56-1.79) for caregivers who did not own their own home. Compared with the highest SES index quartile, the aORs for better performance by SES quartile in descending order were 1.24 (0.60-2.54), 0.76 (0.37-1.58), and 0.39 (0.18-0.86) for numeracy and 0.88 (0.41-1.85), 0.77 (0.35-1.66), and 0.32 (0.14-0.72) for literacy. No interactions were identified between SES and CKD stage, child age, or gender.
Across all CKD stages, children from lower SES families are less likely to perform well in literacy and numeracy than those from higher SES households. A higher resolution version of the Graphical abstract is available as Supplementary information.
较低的社会经济地位（SES）与较低的学业成绩有关；然而，在患有慢性肾脏病（CKD）的儿童中，这种关系的研究还很不足。本研究探讨了 SES 与 CKD 患儿学业成绩之间的关系。
共招募了 377 名年龄在 6-18 岁、CKD 1-5 期（n=199）、透析（n=43）或肾移植（n=135）的参与者。使用多变量逻辑回归，研究了五种 SES 测量值和综合 SES 指数与父母评定的算数和读写能力平均或以上的关系。
参与者的中位年龄为 12.6 岁（IQR 8.9-15.5）。与 SES 较高的家庭相比，父母受教育程度较低、家庭收入较低、父母失业、父母自评经济状况较差和父母无房的儿童在算数和读写方面表现更好的调整后比值比（aOR）（95%CI）分别为 0.71（0.44-1.15）和 0.75（0.45-1.23）、0.46（0.26-0.80）和 0.53（0.30-0.93）、0.52（0.32-0.85）和 0.44（0.26-0.73）、0.68（0.41-1.12）和 0.59（0.35-1.00）、0.93（0.53-1.64）和 1.00（0.56-1.79）。与 SES 指数最高的四分位相比，SES 指数降序四分位的表现更好的 aOR 分别为 1.24（0.60-2.54）、0.76（0.37-1.58）和 0.39（0.18-0.86）用于算数，0.88（0.41-1.85）、0.77（0.35-1.66）和 0.32（0.14-0.72）用于读写。在 CKD 分期、儿童年龄或性别方面均未发现 SES 与 SES 之间存在交互作用。
在所有 CKD 分期中，来自较低 SES 家庭的儿童在读写和算数方面的表现不如来自较高 SES 家庭的儿童。图形摘要的更高分辨率版本可作为补充信息获得。
