Poverty and racial disparities in kidney disease: the REGARDS study

Am J Nephrol. 2010;32(1):38-46. doi: 10.1159/000313883. Epub 2010 May 31.

Abstract

There are pronounced disparities among black compared to white Americans for risk of end-stage renal disease. This study examines whether similar relationships exist between poverty and racial disparities in chronic kidney disease (CKD) prevalence.

Methods: We studied 22,538 participants in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study. We defined individual poverty as family income below USD 15,000 and a neighborhood as poor if 25% or more of the households were below the federal poverty level.

Results: As the estimated glomerular filtration rate (GFR) declined from 50-59 to 10-19 ml/min/ 1.73 m2, the black:white odds ratio (OR) for impaired kidney function increased from 0.74 (95% CI 0.66, 0.84) to 2.96 (95% CI 1.96, 5.57). Controlling for individual income below poverty, community poverty, demographic and comorbid characteristics attenuated the black:white prevalence to an OR of 0.65 (95% CI 0.57, 0.74) among individuals with a GFR of 59-50 ml/min/1.73 m2 and an OR of 2.21 (95% CI 1.25, 3.93) among individuals with a GFR between 10 and 19 ml/min/ 1.73 m2.

Conclusion: Household, but not community poverty, was independently associated with CKD and attenuated but did not fully account for differences in CKD prevalence between whites and blacks.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • African Americans / statistics & numerical data*
  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Creatinine / blood
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Income / statistics & numerical data
  • Male
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Prevalence
  • Renal Insufficiency, Chronic / economics
  • Renal Insufficiency, Chronic / ethnology*
  • Risk Factors
  • Severity of Illness Index

Substances

  • Creatinine