Association of functional and structural social support with chronic kidney disease among African Americans: The Jackson Heart Study

Rasheeda K. Hall, Clemontina A. Davenport, Mario Sims, Cathleen Colón-Emeric, Tiffany Washington, Jennifer Clair Russell, Jane Pendergast, Nrupen Bhavsar, Julia Scialla, Crystal C. Tyson, Wei Wang, Yuan I. Min, Bessie Young, Leigh Boulware, Clarissa Diamantidis

Research output: Contribution to journalArticle

Abstract

Background: There is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an African American cohort. We also examined whether age modifies the association between social support and kidney function decline. Methods: We identified Jackson Heart Study (JHS) participants with baseline (Exam in 2000-2004) functional and structural social support data via the Interpersonal Support Evaluation List (ISEL) and social network size questions, respectively. With ISEL as our primary exposure variable, we performed multivariable regression models to evaluate the association between social support and prevalent CKD [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or urine albumin-creatinine ratio (ACR) ≥30 mg/g], eGFR decline, and rapid renal function decline (RRFD) (> 30% decrease in eGFR over approximately 10 years). All models were adjusted for baseline sociodemographics, diabetes, hypertension, smoking status, and body mass index; models for eGFR decline and RRFD were additionally adjusted for eGFR and ACR. In models for eGFR decline, we assessed for interaction between age and social support. For secondary analyses, we replaced ISEL with its individual domains (appraisal, belonging, self-esteem, and tangible) and social network size in separate models as exposure variables. Results: Of 5301 JHS participants, 4015 (76%) completed the ISEL at baseline. 843 (21%) had low functional social support (ISEL score < 32). Participants with low (vs. higher) functional social support were more likely to have lower income (47% vs. 28%), be current or former tobacco users (39% vs. 30%), have diabetes (25% vs. 21%) or CKD (14% vs. 12%). After multivariable adjustment, neither ISEL or social network size were independently associated with prevalent CKD, eGFR decline, or RRFD. Of the ISEL domains, only higher self-esteem was associated with lower odds of prevalent CKD [OR 0.94 (95% CI 0.89-0.99)]. The associations between social support measures and eGFR decline were not modified by age. Conclusions: In this African-American cohort, social support was not associated with prevalent CKD or kidney function decline. Further inquiry of self-esteem's role in CKD self-management and renal outcomes is warranted.

Original languageEnglish (US)
Article number262
JournalBMC nephrology
Volume20
Issue number1
DOIs
StatePublished - Jul 15 2019

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Chronic Renal Insufficiency
Social Support
African Americans
Glomerular Filtration Rate
Kidney
Self Concept
Social Adjustment
Self Care
Disease Management
Tobacco
Body Mass Index
Smoking
Hypertension

Keywords

  • Aged
  • Chronic renal insufficiency
  • Minority health
  • Social network

ASJC Scopus subject areas

  • Nephrology

Cite this

Association of functional and structural social support with chronic kidney disease among African Americans : The Jackson Heart Study. / Hall, Rasheeda K.; Davenport, Clemontina A.; Sims, Mario; Colón-Emeric, Cathleen; Washington, Tiffany; Clair Russell, Jennifer; Pendergast, Jane; Bhavsar, Nrupen; Scialla, Julia; Tyson, Crystal C.; Wang, Wei; Min, Yuan I.; Young, Bessie; Boulware, Leigh; Diamantidis, Clarissa.

In: BMC nephrology, Vol. 20, No. 1, 262, 15.07.2019.

Research output: Contribution to journalArticle

Hall, RK, Davenport, CA, Sims, M, Colón-Emeric, C, Washington, T, Clair Russell, J, Pendergast, J, Bhavsar, N, Scialla, J, Tyson, CC, Wang, W, Min, YI, Young, B, Boulware, L & Diamantidis, C 2019, 'Association of functional and structural social support with chronic kidney disease among African Americans: The Jackson Heart Study', BMC nephrology, vol. 20, no. 1, 262. https://doi.org/10.1186/s12882-019-1432-9
Hall, Rasheeda K. ; Davenport, Clemontina A. ; Sims, Mario ; Colón-Emeric, Cathleen ; Washington, Tiffany ; Clair Russell, Jennifer ; Pendergast, Jane ; Bhavsar, Nrupen ; Scialla, Julia ; Tyson, Crystal C. ; Wang, Wei ; Min, Yuan I. ; Young, Bessie ; Boulware, Leigh ; Diamantidis, Clarissa. / Association of functional and structural social support with chronic kidney disease among African Americans : The Jackson Heart Study. In: BMC nephrology. 2019 ; Vol. 20, No. 1.
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abstract = "Background: There is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an African American cohort. We also examined whether age modifies the association between social support and kidney function decline. Methods: We identified Jackson Heart Study (JHS) participants with baseline (Exam in 2000-2004) functional and structural social support data via the Interpersonal Support Evaluation List (ISEL) and social network size questions, respectively. With ISEL as our primary exposure variable, we performed multivariable regression models to evaluate the association between social support and prevalent CKD [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or urine albumin-creatinine ratio (ACR) ≥30 mg/g], eGFR decline, and rapid renal function decline (RRFD) (> 30{\%} decrease in eGFR over approximately 10 years). All models were adjusted for baseline sociodemographics, diabetes, hypertension, smoking status, and body mass index; models for eGFR decline and RRFD were additionally adjusted for eGFR and ACR. In models for eGFR decline, we assessed for interaction between age and social support. For secondary analyses, we replaced ISEL with its individual domains (appraisal, belonging, self-esteem, and tangible) and social network size in separate models as exposure variables. Results: Of 5301 JHS participants, 4015 (76{\%}) completed the ISEL at baseline. 843 (21{\%}) had low functional social support (ISEL score < 32). Participants with low (vs. higher) functional social support were more likely to have lower income (47{\%} vs. 28{\%}), be current or former tobacco users (39{\%} vs. 30{\%}), have diabetes (25{\%} vs. 21{\%}) or CKD (14{\%} vs. 12{\%}). After multivariable adjustment, neither ISEL or social network size were independently associated with prevalent CKD, eGFR decline, or RRFD. Of the ISEL domains, only higher self-esteem was associated with lower odds of prevalent CKD [OR 0.94 (95{\%} CI 0.89-0.99)]. The associations between social support measures and eGFR decline were not modified by age. Conclusions: In this African-American cohort, social support was not associated with prevalent CKD or kidney function decline. Further inquiry of self-esteem's role in CKD self-management and renal outcomes is warranted.",
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T1 - Association of functional and structural social support with chronic kidney disease among African Americans

T2 - The Jackson Heart Study

AU - Hall, Rasheeda K.

AU - Davenport, Clemontina A.

AU - Sims, Mario

AU - Colón-Emeric, Cathleen

AU - Washington, Tiffany

AU - Clair Russell, Jennifer

AU - Pendergast, Jane

AU - Bhavsar, Nrupen

AU - Scialla, Julia

AU - Tyson, Crystal C.

AU - Wang, Wei

AU - Min, Yuan I.

AU - Young, Bessie

AU - Boulware, Leigh

AU - Diamantidis, Clarissa

PY - 2019/7/15

Y1 - 2019/7/15

N2 - Background: There is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an African American cohort. We also examined whether age modifies the association between social support and kidney function decline. Methods: We identified Jackson Heart Study (JHS) participants with baseline (Exam in 2000-2004) functional and structural social support data via the Interpersonal Support Evaluation List (ISEL) and social network size questions, respectively. With ISEL as our primary exposure variable, we performed multivariable regression models to evaluate the association between social support and prevalent CKD [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or urine albumin-creatinine ratio (ACR) ≥30 mg/g], eGFR decline, and rapid renal function decline (RRFD) (> 30% decrease in eGFR over approximately 10 years). All models were adjusted for baseline sociodemographics, diabetes, hypertension, smoking status, and body mass index; models for eGFR decline and RRFD were additionally adjusted for eGFR and ACR. In models for eGFR decline, we assessed for interaction between age and social support. For secondary analyses, we replaced ISEL with its individual domains (appraisal, belonging, self-esteem, and tangible) and social network size in separate models as exposure variables. Results: Of 5301 JHS participants, 4015 (76%) completed the ISEL at baseline. 843 (21%) had low functional social support (ISEL score < 32). Participants with low (vs. higher) functional social support were more likely to have lower income (47% vs. 28%), be current or former tobacco users (39% vs. 30%), have diabetes (25% vs. 21%) or CKD (14% vs. 12%). After multivariable adjustment, neither ISEL or social network size were independently associated with prevalent CKD, eGFR decline, or RRFD. Of the ISEL domains, only higher self-esteem was associated with lower odds of prevalent CKD [OR 0.94 (95% CI 0.89-0.99)]. The associations between social support measures and eGFR decline were not modified by age. Conclusions: In this African-American cohort, social support was not associated with prevalent CKD or kidney function decline. Further inquiry of self-esteem's role in CKD self-management and renal outcomes is warranted.

AB - Background: There is limited evidence on the relationship between social support and renal outcomes in African Americans. We sought to determine the association of social support with prevalent chronic kidney disease (CKD) and kidney function decline in an African American cohort. We also examined whether age modifies the association between social support and kidney function decline. Methods: We identified Jackson Heart Study (JHS) participants with baseline (Exam in 2000-2004) functional and structural social support data via the Interpersonal Support Evaluation List (ISEL) and social network size questions, respectively. With ISEL as our primary exposure variable, we performed multivariable regression models to evaluate the association between social support and prevalent CKD [estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 or urine albumin-creatinine ratio (ACR) ≥30 mg/g], eGFR decline, and rapid renal function decline (RRFD) (> 30% decrease in eGFR over approximately 10 years). All models were adjusted for baseline sociodemographics, diabetes, hypertension, smoking status, and body mass index; models for eGFR decline and RRFD were additionally adjusted for eGFR and ACR. In models for eGFR decline, we assessed for interaction between age and social support. For secondary analyses, we replaced ISEL with its individual domains (appraisal, belonging, self-esteem, and tangible) and social network size in separate models as exposure variables. Results: Of 5301 JHS participants, 4015 (76%) completed the ISEL at baseline. 843 (21%) had low functional social support (ISEL score < 32). Participants with low (vs. higher) functional social support were more likely to have lower income (47% vs. 28%), be current or former tobacco users (39% vs. 30%), have diabetes (25% vs. 21%) or CKD (14% vs. 12%). After multivariable adjustment, neither ISEL or social network size were independently associated with prevalent CKD, eGFR decline, or RRFD. Of the ISEL domains, only higher self-esteem was associated with lower odds of prevalent CKD [OR 0.94 (95% CI 0.89-0.99)]. The associations between social support measures and eGFR decline were not modified by age. Conclusions: In this African-American cohort, social support was not associated with prevalent CKD or kidney function decline. Further inquiry of self-esteem's role in CKD self-management and renal outcomes is warranted.

KW - Aged

KW - Chronic renal insufficiency

KW - Minority health

KW - Social network

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