Neighborhood socioeconomic status and risk of hospitalization in patients with chronic kidney disease
Year: 2020
Type: article
Abstract: Patients with chronic kidney disease (CKD) experience significantly greater morbidity than the general population. The hospitalization rate for patients with CKD is significantly higher than the general population. The extent to which neighborhood-level socioeconomic status (SES) is associated with hospitalization has been less explored, both in the general population and among those with CKD.We evaluated the relationship between neighborhood SES and hospitalizations for adults with CKD participating in the Chronic Renal Insufficiency Cohort Study. Neighborhood SES quartiles were created utilizing a validated neighborhood-level SES summary measure expressed as z-scores for 6 census-derived variables. The relationship between neighborhood SES and hospitalizations was examined using Poisson regression models after adjusting for demographic characteristics, individual SES, lifestyle, and clinical factors while taking into account clustering within clinical centers and census block groups.Among 3291 participants with neighborhood SES data, mean age was 58 years, 55% were male, 41% non-Hispanic white, 49% had diabetes, and mean estimated glomerular filtration rate (eGFR) was 44 ml/min/1.73 m. In the fully adjusted model, compared to individuals in the highest SES neighborhood quartile, individuals in the lowest SES neighborhood quartile had higher risk for all-cause hospitalization (rate ratio [RR], 1.28, 95% CI, 1.09-1.51) and non-cardiovascular hospitalization (RR 1.30, 95% CI, 1.10-1.55). The association with cardiovascular hospitalization was in the same direction but not statistically significant (RR 1.21, 95% CI, 0.97-1.52).Neighborhood SES is associated with risk for hospitalization in individuals with CKD even after adjusting for individual SES, lifestyle, and clinical factors.
Source: Medicine
Authors: Milda R. Saunders, Ana C. Ricardo, Jinsong Chen, Amanda H. Anderson, Esteban A. Cedillo-Couvert, Michael J. Fischer, Jesus Hernandez-Rivera, Margaret T. Hicken, Jesse Y. Hsu, Xiaoming Zhang, Denise Hynes, Bernard Jaar, John W. Kusek, Panduranga Rao, Harold I. Feldman, Alan S. Go, James P. Lash
Institutions: University of Chicago, University of Illinois Chicago, University of Pennsylvania, Jesse Brown VA Medical Center, Tulane University, University of Michigan, Institute for Social Research, Oregon State University, Johns Hopkins University, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Kaiser Permanente, Kaiser Permanente Northern California
Language: English
Subfield: Health
Field: Social Sciences
Domain: Social Sciences
Open Access status: gold
Estimated APC paid: $1,950
Funders: University of Maryland Foundation, Kaiser Permanente, National Institutes of Health, Perelman School of Medicine, University of Pennsylvania, National Institute of General Medical Sciences, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: Clinical and Translational Science Institute, G1710642513, Hispanic Chronic Renal Insufficiency Cohort(CRIC) Study, Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Study, G3487450158, General Clinical Research Center, The Interactive Roles of Neighborhood Characteristics and Genetic Risk in Racial Inequalities in CKD, Gender Disparities and Vascular Function in Chronic Kidney Disease Outcomes, Center for Clinical and Translational Science, G6677863498, Michigan Institute for Clinical and Health Research (MCHR), Michigan Institute for Clinical and Health Research (MICHR), Institute for Clinical and Translational Research, Institutional Clinical and Translational Science Award, Health Disparities in Chronic Kidney Disease Mentoring Program, G8287218166, Clinical and Translational Science Collaborative of Cleveland, Clinical and Translational Science Collaborative of Cleveland, G898372635, Tulane COBRE for Clinical and Translational Research in Cardiometabolic Diseases, Prospective renal insufficiency cohort evaluation: PRICE, Chronic Renal Insufficiency Cohort (CRIC) Study Clinical Center, Continuation of the Chronic Renal Insufficiency Cohort (CRIC), Continuation of the University of Illinois Chicago CRIC Clinical Center, Limited Competition for the Continuation of the Chronic Renal Insufficiency Cohort (CRIC) Hopkins Clinical Center, Tulane Clinical Center for Chronic Renal Insufficiency Cohort Study, Chronic Renal Insufficiency Cohort Limited competition continuation, Chronic Renal Insufficiency Cohort (CRIC) Study
OpenAlex ID: W3041666497