Association of income level with kidney disease severity and progression among children and adolescents with CKD: A report from the chronic kidney disease in children (CKiD) study

Guillermo Hidalgo, Derek Ng, Marva Moxey-Mims, Maria Lourdes Minnick, Tom Blydt-Hansen, Bradley A. Warady, Susan L. Furth

Research output: Contribution to journalArticle

Abstract

Background Among adults, lower socioeconomic status (SES) is a risk factor for chronic kidney disease (CKD), progression to end-stage renal disease, and poor health outcomes; but its impact on young people with CKD is not established. Study Design Prospective cohort study. Settings & Participants 572 children and adolescents aged 1-16 years with mild to moderate CKD residing in the United States and Canada who were enrolled in the Chronic Kidney Disease in Children (CKiD) Study. Predictor Self-reported annual household income category as a proxy measure for SES: ≥$75,000 (high income), $30,000 to 2). After adjusting for baseline differences, average GFR declines per year for the low-, middle-, and high-income categories were -2.3%, -2.7%, and -1.9%, respectively, and were not statistically significantly different among groups. Blood pressure control tended to improve in all groups (z score, -0.10 to -0.04) but higher income was associated with a faster improvement. Each group showed similar deficits in height at baseline. Height deficits diminished over time for participants from high-income families, but not among those from low-income families (z scores for height per year, 0.05 and -0.004, respectively; P = 0.03 for comparison of high and low income). Limitations Income is an imperfect measure for SES; CKiD participants are not representative of children and adolescents with CKD who are uninsured or not receiving care; statistical power to detect associations by income level is limited. Conclusions GFR decline was similar across income groups but better improvement in BP was observed among those with high income. Children and adolescents with CKD from lower income households are at higher risk of impaired growth.

Original languageEnglish (US)
Pages (from-to)1087-1094
Number of pages8
JournalAmerican Journal of Kidney Diseases
Volume62
Issue number6
DOIs
StatePublished - Dec 2013

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Kidney Diseases
Chronic Renal Insufficiency
Disease Progression
Social Class
Proxy
Chronic Kidney Failure
Canada
Cohort Studies
Prospective Studies
Blood Pressure

Keywords

  • adolescents
  • children
  • chronic kidney disease
  • growth
  • progression
  • Socioeconomic status

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

Cite this

Association of income level with kidney disease severity and progression among children and adolescents with CKD : A report from the chronic kidney disease in children (CKiD) study. / Hidalgo, Guillermo; Ng, Derek; Moxey-Mims, Marva; Minnick, Maria Lourdes; Blydt-Hansen, Tom; Warady, Bradley A.; Furth, Susan L.

In: American Journal of Kidney Diseases, Vol. 62, No. 6, 12.2013, p. 1087-1094.

Research output: Contribution to journalArticle

Hidalgo, Guillermo ; Ng, Derek ; Moxey-Mims, Marva ; Minnick, Maria Lourdes ; Blydt-Hansen, Tom ; Warady, Bradley A. ; Furth, Susan L. / Association of income level with kidney disease severity and progression among children and adolescents with CKD : A report from the chronic kidney disease in children (CKiD) study. In: American Journal of Kidney Diseases. 2013 ; Vol. 62, No. 6. pp. 1087-1094.
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abstract = "Background Among adults, lower socioeconomic status (SES) is a risk factor for chronic kidney disease (CKD), progression to end-stage renal disease, and poor health outcomes; but its impact on young people with CKD is not established. Study Design Prospective cohort study. Settings & Participants 572 children and adolescents aged 1-16 years with mild to moderate CKD residing in the United States and Canada who were enrolled in the Chronic Kidney Disease in Children (CKiD) Study. Predictor Self-reported annual household income category as a proxy measure for SES: ≥$75,000 (high income), $30,000 to 2). After adjusting for baseline differences, average GFR declines per year for the low-, middle-, and high-income categories were -2.3{\%}, -2.7{\%}, and -1.9{\%}, respectively, and were not statistically significantly different among groups. Blood pressure control tended to improve in all groups (z score, -0.10 to -0.04) but higher income was associated with a faster improvement. Each group showed similar deficits in height at baseline. Height deficits diminished over time for participants from high-income families, but not among those from low-income families (z scores for height per year, 0.05 and -0.004, respectively; P = 0.03 for comparison of high and low income). Limitations Income is an imperfect measure for SES; CKiD participants are not representative of children and adolescents with CKD who are uninsured or not receiving care; statistical power to detect associations by income level is limited. Conclusions GFR decline was similar across income groups but better improvement in BP was observed among those with high income. Children and adolescents with CKD from lower income households are at higher risk of impaired growth.",
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T1 - Association of income level with kidney disease severity and progression among children and adolescents with CKD

T2 - A report from the chronic kidney disease in children (CKiD) study

AU - Hidalgo, Guillermo

AU - Ng, Derek

AU - Moxey-Mims, Marva

AU - Minnick, Maria Lourdes

AU - Blydt-Hansen, Tom

AU - Warady, Bradley A.

AU - Furth, Susan L.

PY - 2013/12

Y1 - 2013/12

N2 - Background Among adults, lower socioeconomic status (SES) is a risk factor for chronic kidney disease (CKD), progression to end-stage renal disease, and poor health outcomes; but its impact on young people with CKD is not established. Study Design Prospective cohort study. Settings & Participants 572 children and adolescents aged 1-16 years with mild to moderate CKD residing in the United States and Canada who were enrolled in the Chronic Kidney Disease in Children (CKiD) Study. Predictor Self-reported annual household income category as a proxy measure for SES: ≥$75,000 (high income), $30,000 to 2). After adjusting for baseline differences, average GFR declines per year for the low-, middle-, and high-income categories were -2.3%, -2.7%, and -1.9%, respectively, and were not statistically significantly different among groups. Blood pressure control tended to improve in all groups (z score, -0.10 to -0.04) but higher income was associated with a faster improvement. Each group showed similar deficits in height at baseline. Height deficits diminished over time for participants from high-income families, but not among those from low-income families (z scores for height per year, 0.05 and -0.004, respectively; P = 0.03 for comparison of high and low income). Limitations Income is an imperfect measure for SES; CKiD participants are not representative of children and adolescents with CKD who are uninsured or not receiving care; statistical power to detect associations by income level is limited. Conclusions GFR decline was similar across income groups but better improvement in BP was observed among those with high income. Children and adolescents with CKD from lower income households are at higher risk of impaired growth.

AB - Background Among adults, lower socioeconomic status (SES) is a risk factor for chronic kidney disease (CKD), progression to end-stage renal disease, and poor health outcomes; but its impact on young people with CKD is not established. Study Design Prospective cohort study. Settings & Participants 572 children and adolescents aged 1-16 years with mild to moderate CKD residing in the United States and Canada who were enrolled in the Chronic Kidney Disease in Children (CKiD) Study. Predictor Self-reported annual household income category as a proxy measure for SES: ≥$75,000 (high income), $30,000 to 2). After adjusting for baseline differences, average GFR declines per year for the low-, middle-, and high-income categories were -2.3%, -2.7%, and -1.9%, respectively, and were not statistically significantly different among groups. Blood pressure control tended to improve in all groups (z score, -0.10 to -0.04) but higher income was associated with a faster improvement. Each group showed similar deficits in height at baseline. Height deficits diminished over time for participants from high-income families, but not among those from low-income families (z scores for height per year, 0.05 and -0.004, respectively; P = 0.03 for comparison of high and low income). Limitations Income is an imperfect measure for SES; CKiD participants are not representative of children and adolescents with CKD who are uninsured or not receiving care; statistical power to detect associations by income level is limited. Conclusions GFR decline was similar across income groups but better improvement in BP was observed among those with high income. Children and adolescents with CKD from lower income households are at higher risk of impaired growth.

KW - adolescents

KW - children

KW - chronic kidney disease

KW - growth

KW - progression

KW - Socioeconomic status

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