TY - JOUR
T1 - SES, Chronic Kidney Disease, and Race in the U.S.
T2 - A Systematic Review and Meta-analysis
AU - Vart, Priya
AU - van Zon, Sander K. R.
AU - Gansevoort, Ron T.
AU - Bültmann, Ute
AU - Reijneveld, Sijmen A.
N1 - Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
PY - 2017/11
Y1 - 2017/11
N2 - Context: The risk of chronic kidney disease (CKD) in the U.S. is higher in individuals with low SES than in those with high SES. However, differences in these risks between African Americans and whites are unclear.Evidence acquisition: Studies published through August 30, 2016 in Medline and EMBASE were searched. From the seven studies (1,775,267 participants) that met inclusion criteria, association estimates were pooled by race in meta-analysis. The ratio of association estimates and the corresponding 95% CIs for African Americans and whites were also pooled in meta-analysis. Additionally, meta-regression analysis was used to explore whether race is related to the strength of SES-CKD association. The analysis was conducted in September 2016.Evidence synthesis: The risk of CKD in low-SES people was 58% higher in African Americans (relative risk = 1.58, 95% CI = 1.33, 1.84) and 91% higher in whites (relative risk = 1.91, 95% CI = 1.47, 2.35) compared with their high-SES counterparts. The relative risk of CKD in low SES (versus high SES) was lower in African Americans than in whites (relative risk ratio = 0.71, 95% CI = 0.65, 0.77). Results from meta-regression analyses also indicated that race is potentially related to the strength of the association between low SES and CKD (p for difference between whites and African Americans = 0.001).Conclusions: The risk of CKD in low SES (versus high SES) is higher in whites than in African Americans.
AB - Context: The risk of chronic kidney disease (CKD) in the U.S. is higher in individuals with low SES than in those with high SES. However, differences in these risks between African Americans and whites are unclear.Evidence acquisition: Studies published through August 30, 2016 in Medline and EMBASE were searched. From the seven studies (1,775,267 participants) that met inclusion criteria, association estimates were pooled by race in meta-analysis. The ratio of association estimates and the corresponding 95% CIs for African Americans and whites were also pooled in meta-analysis. Additionally, meta-regression analysis was used to explore whether race is related to the strength of SES-CKD association. The analysis was conducted in September 2016.Evidence synthesis: The risk of CKD in low-SES people was 58% higher in African Americans (relative risk = 1.58, 95% CI = 1.33, 1.84) and 91% higher in whites (relative risk = 1.91, 95% CI = 1.47, 2.35) compared with their high-SES counterparts. The relative risk of CKD in low SES (versus high SES) was lower in African Americans than in whites (relative risk ratio = 0.71, 95% CI = 0.65, 0.77). Results from meta-regression analyses also indicated that race is potentially related to the strength of the association between low SES and CKD (p for difference between whites and African Americans = 0.001).Conclusions: The risk of CKD in low SES (versus high SES) is higher in whites than in African Americans.
KW - STAGE RENAL-DISEASE
KW - SOCIOECONOMIC-STATUS
KW - UNITED-STATES
KW - RACIAL-DIFFERENCES
KW - ATHEROSCLEROSIS RISK
KW - AFRICAN-AMERICAN
KW - ESRD INCIDENCE
KW - HEALTH
KW - POPULATION
KW - CKD
U2 - 10.1016/j.amepre.2017.06.036
DO - 10.1016/j.amepre.2017.06.036
M3 - Review article
C2 - 28869090
SN - 0749-3797
VL - 53
SP - 730
EP - 739
JO - American Journal of Preventive Medicine
JF - American Journal of Preventive Medicine
IS - 5
ER -