| アブストラクト | BACKGROUND: Several studies have investigated the effect of socioeconomic deprivation on cardiovascular disease (CVD) and diabetes; less is known about its effect on chronic kidney disease (CKD). We aimed to measure the association between deprivation, CKD Stages 4-5 and end-stage renal disease (ESRD) in a general population sample. METHODS: This observational study examined 1 405 016 participants from the English Clinical Practice Research Datalink (2000-14), linked to hospital discharge data and death certification. Deprivation was assessed according to the participant's postcode. Cox models were used to estimate hazard ratios (HRs) for CKD Stages 4-5 and ESRD, adjusting for age and sex, and additionally for smoking status, body mass index, diabetes, systolic blood pressure, prior CVD and estimated glomerular filtration rate (eGFR) at baseline. RESULTS: During 7.5 years of median follow-up, 11 490 individuals developed CKD Stages 4-5 and 1068 initiated ESRD. After adjustment for age and sex, the HRs and confidence interval (CI) comparing those in the 20% most deprived of the population to the 20% least deprived were 1.76 (95% CI 1.68-1.84) and 1.82 (95% CI 1.56-2.12) for CKD Stages 4-5 and ESRD, respectively. Further adjustment for known risk factors and eGFR substantially attenuated these HRs. Adding our results to all known cohort studies produced a pooled relative risk of 1.61 (95% CI 1.42-1.83) for ESRD, for comparisons between highest to lowest categories of deprivation. CONCLUSION: Socioeconomic deprivation is independently associated with an increased hazard of CKD Stages 4-5 and ESRD, but in large part may be mediated by known risk factors. |
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| ジャーナル名 | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association |
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| 投稿日 | 2019/7/23 |
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| 投稿者 | Weldegiorgis, Misghina; Smith, Margaret; Herrington, William G; Bankhead, Clare; Woodward, Mark |
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| 組織名 | The George Institute for Global Health, Nuffield Department of Women's and;Reproductive Health, University of Oxford, Oxford, UK.;The George Institute for Global Health, Faculty of Medicine, University of New;South Wales Sydney, Sydney, Australia.;Nuffield Department of Primary Care Health Sciences, University of Oxford,;Oxford, UK.;NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS;Foundation Trust, Oxford, UK.;Nuffield Department of Population Health, University of Oxford, Oxford, UK.;Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31329936/ |
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