Abstract
Aims
Chronic kidney disease (CKD) poses a significant health burden in the United States (US). Although earlier studies investigated income disparities in other chronic diseases, limited research has been carried out for CKD in recent years. We investigated income disparities in the prevalence and trends of CKD among US adults.
Subjects and methods
This cross-sectional study analyzed National Health and Nutrition Examination Survey 2003–18 data. Survey periods were grouped as 2003–06, 2007–10, 2011–14, and 2015–18. Using glomerular filtration rate and urinary albumin-creatinine ratio from CKD-epidemiology equation, individuals ≥20-year-old were classified into stages of CKD. Income was derived from family income to poverty ratio and equally stratified as low-, middle-, and high-income.
Results
In all periods, a reduction in CKD prevalence was observed as income-level increased. In 2003–06, the prevalence (95% confidence interval [CI]) of CKD was 17.8% (15.6%–20.3%), 14.7% (13.1%–16.4%), and 11.5% (10.3%–12.9%) among low-, middle-, and high-income people, respectively. It remained similar in 2007–10 and 2011–14. In 2015–18, this prevalence (95% CI) was 17.9% (16.5%–19.5%), 15.9% (14.6%–17.2%), and 10.2% (8.8%–11.8%) among low-, middle, and high-income people, respectively. Similar differences were detected across most age, gender, and race/ethnicity categories. Income differences were also observed in prevalence of CKD risk factors, including diabetes, obesity, metabolic syndrome, and smoking.
Conclusion
While there was no increase in overall CKD prevalence, there could be an association between CKD and income, and low- or middle-income people had higher prevalence of CKD than high-income people. Lifestyle intervention and chronic disease-related health service provision need to consider the income disparity in CKD burden to improve the health and wellbeing of the US population.
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Availability of Data
Data is freely available from Centers for Diseases Control and Prevention’s website.
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We did not use any copyrighted materials, instruments, tools, data, or surveys, and thank all survey participants.
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Conception and design: G. Kibria.
Analysis and interpretation of the data: G. Kibria and Z. Hasan.
Drafting of the article: G. Kibria.
Critical revision of the article for important intellectual content: Z. Hasan.
Final approval of the article: G. Kibria and Z. Hasan.
Dr. Kibria had full access to the research and writing processes and takes responsibility for the integrity of the paper.
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Al Kibria, G.M., Hasan, M.Z. Income disparities in prevalence and trends of chronic kidney disease among US adults, 2003–18. J Public Health (Berl.) 30, 2181–2189 (2022). https://doi.org/10.1007/s10389-021-01505-1
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DOI: https://doi.org/10.1007/s10389-021-01505-1