Abstract
Prevention of Chronic Kidney Disease and its Complications: The Role of Socioeconomic Status
Chronic kidney disease (CKD) is a major cause of the global burden of disease, leading to a call for better CKD prevention. This requires an improved understanding of the risk factors for CKD, beyond the traditional risk factors like diabetes and hypertension. One such novel risk factor is low socioeconomic status (SES). This thesis attempts to extend our knowledge on the role of SES in the etiology of CKD and to discuss the consequences for CKD prevention. For this purpose, we summarized all evidence from epidemiological studies on this topic and analyzed large US and Dutch databases. This thesis suggests that the risk of CKD in low SES groups is fairly high compared to high SES groups (~40% higher). To obtain better estimates of the additional risks people with low SES have, the measurement of SES can be improved. For the Netherlands, risk seems to be highest for people with low educational attainment whereas in the US risk is highest for people with low income. The additional CKD risk in people with low income in the US may be due to costs related to use of health care. Improvement of the measurement of markers used to detect CKD can also be helpful in identifying CKD people at high risk of adverse health outcomes. Finally, expanding the prevailing CKD screening approach to include also low SES people may be warranted, though future studies are required to evaluate the cost-effectiveness of such a screening approach.
Chronic kidney disease (CKD) is a major cause of the global burden of disease, leading to a call for better CKD prevention. This requires an improved understanding of the risk factors for CKD, beyond the traditional risk factors like diabetes and hypertension. One such novel risk factor is low socioeconomic status (SES). This thesis attempts to extend our knowledge on the role of SES in the etiology of CKD and to discuss the consequences for CKD prevention. For this purpose, we summarized all evidence from epidemiological studies on this topic and analyzed large US and Dutch databases. This thesis suggests that the risk of CKD in low SES groups is fairly high compared to high SES groups (~40% higher). To obtain better estimates of the additional risks people with low SES have, the measurement of SES can be improved. For the Netherlands, risk seems to be highest for people with low educational attainment whereas in the US risk is highest for people with low income. The additional CKD risk in people with low income in the US may be due to costs related to use of health care. Improvement of the measurement of markers used to detect CKD can also be helpful in identifying CKD people at high risk of adverse health outcomes. Finally, expanding the prevailing CKD screening approach to include also low SES people may be warranted, though future studies are required to evaluate the cost-effectiveness of such a screening approach.
| Translated title of the contribution | Preventie van chronische nierziekte en de gevolgen daarvan: De rol van sociaal-economische status |
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| Original language | English |
| Qualification | Doctor of Philosophy |
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| Award date | 13-Apr-2015 |
| Place of Publication | [Groningen] |
| Publisher | |
| Print ISBNs | 978-90-367-7667-7 |
| Electronic ISBNs | 978-90-367-7666-0 |
| Publication status | Published - 2015 |