Abstract
Background: Chronic kidney disease (CKD) is a pre-condition for end-stage kidney disease (ESKD) undergoing hemodialysis, as well as a risk factor for cardiovascular disease. Therefore, it is vital that CKD prevention measures be established. In particular, socioeconomic status (SES), as represented by income, contributes to non-communicable diseases like CKD. The purpose of this study was to examine the independent association between CKD and individual SES in Japan, with consideration of other metabolic risks. Methods: In the present study, we analyzed the 2011 National Health and Nutrition Survey by the Ministry of Health, Labor, and Welfare. Specifically, we analyzed 3,557 people out of 8,762 whose serum creatinine was measured. Logistic regression analysis was used to calculate the odds ratio (OR) of CKD by income distinction, after adjustment for age and metabolic risks (obesity, diabetes mellitus, dyslipidemia, and hypertension), which were assessed at the medical examination. Results: CKD was found in 385 participants (10.8%) and was associated with greater age, obesity, higher levels of low-density lipoprotein cholesterol, triglyceride, and glycated hemoglobin, and lower levels of hemoglobin and high-density lipoprotein cholesterol. The adjusted model indicated a significant association between lower income and CKD: the OR of the low income group (<2 million yen) was 1.33 (95% confidence interval: 1.01 - 1.78) in comparison with the high income group. Conclusions: The results of the present study indicate a substantial relationship between individual lower income status and CKD in Japan, where healthcare is easy to access. To prevent ESKD and cardiovascular diseases, early detection of CKD and its metabolic risks is necessary, especially among the socioeconomically vulnerable population.
Highlights
The number of patients with end-stage kidney disease (ESKD) undergoing hemodialysis has been increasing in most parts of the world, and the worldwide medical expenses associated with hemodialysis will increase to 1.1 billion US dollars within the 10 years [1]
chronic kidney disease (CKD) is a pre-condition for ESKD, as well as a risk factor for cardiovascular disease (CVD), which is the main cause of death worldwide [4] [5] [6]
The results of the present study indicate that people of lower income have an approximately 30% greater prevalence of CKD than those of higher income in multivariate regression analysis, after adjustment for age, sex, Hb, Alb, diabetes mellitus (DM), DL, HT, and obesity
Summary
The number of patients with end-stage kidney disease (ESKD) undergoing hemodialysis has been increasing in most parts of the world, and the worldwide medical expenses associated with hemodialysis will increase to 1.1 billion US dollars within the 10 years [1]. It is estimated that 13% of the Japanese population have CKD; the disease is as common as diabetes mellitus (DM) and hypertension (HT) For this reason, it is vital that effective CKD preventive measures be established; this is one of the most important issues in public and national health. Chronic kidney disease (CKD) is a pre-condition for end-stage kidney disease (ESKD) undergoing hemodialysis, as well as a risk factor for cardiovascular disease. Logistic regression analysis was used to calculate the odds ratio (OR) of CKD by income distinction, after adjustment for age and metabolic risks (obesity, diabetes mellitus, dyslipidemia, and hypertension), which were assessed at the medical examination. To prevent ESKD and cardiovascular diseases, early detection of CKD and its metabolic risks is necessary, especially among the socioeconomically vulnerable population
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