The Fifth Clinical Medical College, Shanxi Medical University, Taiyuan, China.
Department of Nephrology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Ren Fail. 2024 Dec;46(2):2367705. doi: 10.1080/0886022X.2024.2367705. Epub 2024 Jul 16.
Previous studies indicate a strong correlation between the incidence of chronic kidney disease (CKD) and lower economic status. However, these studies often struggle to delineate a clear cause-effect relationship, leaving healthcare providers uncertain about how to manage kidney disease in a way that improves patients' financial outcomes. Our study aimed to explore and establish a causal relationship between CKD and socioeconomic status, identifying critical influencing factors. We utilized summary meta-analysis data from the CKDGen Consortium and UK Biobank. Genetic variants identified from these sources served as instrumental variables (IVs) to estimate the association between CKD and socioeconomic status. The presence or absence of CKD, estimated glomerular filtration rate (eGFR), and albuminuria were used as exposures, while income and regional deprivation were analyzed as outcomes. We employed the R packages 'TwoSampleMR' and 'Mendelianrandomization' to conduct both univariable and multivariable Mendelian randomization (MR) analyses, assessing for potential pleiotropy and heterogeneity. Our univariable MR analysis revealed a significant causal relationship between high levels of albuminuria and lower income (OR = 0.84, 95% CI: 0.73-0.96, = 0.013), with no significant pleiotropy detected. In the multivariable MR analysis, both CKD (OR = 0.867, 95% CI: 0.786-0.957, = 0.0045) and eGFR (OR = 0.065, 95% CI: 0.010-0.437, = 0.0049) exhibited significant effects on income. This study underscores that higher albuminuria levels in CKD patients are associated with decreased income and emphasizes the importance of effective management and treatment of albuminuria in CKD patients to mitigate both social and personal economic burdens.
先前的研究表明，慢性肾脏病（CKD）的发病率与较低的经济地位之间存在很强的相关性。然而，这些研究往往难以明确界定因果关系，使医疗保健提供者不确定如何以改善患者经济结果的方式管理肾脏病。我们的研究旨在探索并建立 CKD 与社会经济地位之间的因果关系，确定关键的影响因素。我们利用了 CKDGen 联盟和英国生物库的汇总元分析数据。这些来源确定的遗传变异用作工具变量（IV）来估计 CKD 与社会经济地位之间的关联。CKD 的有无、估计肾小球滤过率（eGFR）和白蛋白尿被用作暴露因素，而收入和地区贫困程度则被分析为结果。我们使用 R 包“TwoSampleMR”和“Mendelianrandomization”进行单变量和多变量孟德尔随机化（MR）分析，评估潜在的混杂和异质性。我们的单变量 MR 分析表明，高水平的白蛋白尿与较低的收入之间存在显著的因果关系（OR=0.84，95%CI：0.73-0.96，P=0.013），未检测到显著的混杂。在多变量 MR 分析中，CKD（OR=0.867，95%CI：0.786-0.957，P=0.0045）和 eGFR（OR=0.065，95%CI：0.010-0.437，P=0.0049）都对收入有显著影响。这项研究强调了 CKD 患者中较高的白蛋白尿水平与收入降低之间的关联，并强调了有效管理和治疗 CKD 患者的白蛋白尿以减轻社会和个人经济负担的重要性。
