TY - JOUR
T1 - Low income and albuminuria among REGARDS (Reasons for geographic and racial differences in stroke) study participants
AU - Crews, Deidra C.
AU - McClellan, William M.
AU - Shoham, David A.
AU - Gao, Liyan
AU - Warnock, David G.
AU - Judd, Suzanne
AU - Muntner, Paul
AU - Miller, Edgar R.
AU - Powe, Neil R.
N1 - Funding Information:
Support: This research project is supported by cooperative agreement U01 NS041588 from the National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Department of Health and Human Service. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NINDS or the NIH. Representatives of the funding agency have been involved in the review of the manuscript but not directly involved in the collection, management, analysis, or interpretation of the data. Dr Crews is supported by the Harold Amos Medical Faculty Development Program of the Robert Wood Johnson Foundation. Dr Powe is supported in part by grant K24DK02643 from the National Institute of Diabetes and Digestive and Kidney Diseases .
PY - 2012/11
Y1 - 2012/11
N2 - Background: Albuminuria is an important risk factor for progressive chronic kidney disease (CKD) and is more prevalent in black than white adults. We sought to determine the association between low income and albuminuria and whether this association differs for blacks and whites. Study Design: Cross-sectional study. Setting & Participants: 9,144 black and 13,684 white US adults 45 years and older in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Predictors: Self-reported annual household income category (<$75,000, $35,000-$74,999, $20,000-$34,999, and <$20,000); black and white race. Outcomes & Measurements: Albuminuria defined as high (30-300 mg/g) or very high (>300 mg/g) urinary albumin-creatinine ratio (ACR). Multinomial logistic regression used to examine the race-stratified association between categories of income and albuminuria (normal, high, or very high ACR). Results: Overall, geometric mean ACR was 10.2 mg/g and was higher for blacks (11.8 mg/g) than whites (9.3 mg/g), P < 0.001. Lower income was associated with a higher prevalence of albuminuria for both whites and blacks in unadjusted analyses. After adjustment for demographics, lifestyle factors, comorbid illnesses, and estimated glomerular filtration rate, there was a trend toward a stronger association between lower income levels and high ACR in blacks (ORs of 1.38 [95% CI, 1.07-1.77], 1.36 [95% CI, 1.05-1.75], and 1.58 [95% CI, 1.21-2.05] for income levels of $35,000-$74,999, $20,000-$34,999, and <$20,000, respectively; reference group is those with income <$75,000) compared with whites (ORs of 0.95 [95% CI, 0.81-1.12], 0.95 [95% CI, 0.79-1.14], and 1.26 [95% CI, 1.02-1.55], respectively); P interaction = 0.08 between race and income. Results were similar for very high ACR and subgroups of participants with diabetes or hypertension. Limitations: Cross-sectional design; not all REGARDS participants provided their annual income. Conclusions: Lower income may be associated more strongly with albuminuria in blacks than whites and may be a determinant of racial disparities in albuminuria.
AB - Background: Albuminuria is an important risk factor for progressive chronic kidney disease (CKD) and is more prevalent in black than white adults. We sought to determine the association between low income and albuminuria and whether this association differs for blacks and whites. Study Design: Cross-sectional study. Setting & Participants: 9,144 black and 13,684 white US adults 45 years and older in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Predictors: Self-reported annual household income category (<$75,000, $35,000-$74,999, $20,000-$34,999, and <$20,000); black and white race. Outcomes & Measurements: Albuminuria defined as high (30-300 mg/g) or very high (>300 mg/g) urinary albumin-creatinine ratio (ACR). Multinomial logistic regression used to examine the race-stratified association between categories of income and albuminuria (normal, high, or very high ACR). Results: Overall, geometric mean ACR was 10.2 mg/g and was higher for blacks (11.8 mg/g) than whites (9.3 mg/g), P < 0.001. Lower income was associated with a higher prevalence of albuminuria for both whites and blacks in unadjusted analyses. After adjustment for demographics, lifestyle factors, comorbid illnesses, and estimated glomerular filtration rate, there was a trend toward a stronger association between lower income levels and high ACR in blacks (ORs of 1.38 [95% CI, 1.07-1.77], 1.36 [95% CI, 1.05-1.75], and 1.58 [95% CI, 1.21-2.05] for income levels of $35,000-$74,999, $20,000-$34,999, and <$20,000, respectively; reference group is those with income <$75,000) compared with whites (ORs of 0.95 [95% CI, 0.81-1.12], 0.95 [95% CI, 0.79-1.14], and 1.26 [95% CI, 1.02-1.55], respectively); P interaction = 0.08 between race and income. Results were similar for very high ACR and subgroups of participants with diabetes or hypertension. Limitations: Cross-sectional design; not all REGARDS participants provided their annual income. Conclusions: Lower income may be associated more strongly with albuminuria in blacks than whites and may be a determinant of racial disparities in albuminuria.
KW - Race
KW - albuminuria
KW - chronic kidney disease
KW - disparity
KW - poverty
KW - socioeconomic status
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U2 - 10.1053/j.ajkd.2012.05.010
DO - 10.1053/j.ajkd.2012.05.010
M3 - Article
C2 - 22694949
AN - SCOPUS:84867572200
VL - 60
SP - 779
EP - 786
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
SN - 0272-6386
IS - 5
ER -