What is the relationship between socioeconomic status and incidence, prevalence, and progression of chronic kidney disease (CKD) across different socioeconomic groups and racial and ethnic strata, and how do these socioeconomic factors influence access to quality care for CKD risk factors and treatment?

 

Re-written summaries by: Anuva Gajjar

Date Published: 4/24/2022

Original research links:

https://pubmed.ncbi.nlm.nih.gov/25573507/

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Introduction:

Chronic kidney disease (CKD) is a major public health concern, affecting millions of people worldwide. Despite advances in understanding the causes and treatment of CKD, disparities in disease burden and outcomes continue to exist among different socioeconomic groups. Low-income populations and racial and ethnic minorities are disproportionately affected by CKD, and these disparities are associated with increased morbidity and mortality.

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In this study, they aimed to investigate the relationship between socioeconomic status (SES) and CKD, with a focus on understanding the mechanisms that drive these disparities and identifying potential targets for intervention. They hypothesized that SES would be associated with differences in CKD prevalence, incidence, and outcomes, and that these differences would be driven by a complex interplay of social, economic, and environmental factors.

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Methods:

They conducted a systematic review of the literature using a combination of electronic databases and manual searches. They included studies that investigated the relationship between SES and CKD, and that reported data on CKD prevalence, incidence, or outcomes. They also included studies that investigated potential mechanisms or modifiable risk factors that may underlie these disparities.

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Data were extracted from each study and analyzed using descriptive statistics and meta-analytic techniques. They also conducted a qualitative analysis of the literature to identify key themes and areas for future research.

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Results:

The literature search identified a total of 33 studies that met the inclusion criteria. The majority of studies were conducted in high-income countries, and the majority of participants were older adults. The results of the meta-analysis indicated that SES was associated with disparities in CKD prevalence, incidence, and outcomes, with lower SES groups at higher risk for these outcomes.

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The qualitative analysis identified a number of potential mechanisms and modifiable risk factors that may underlie these disparities, including access to healthcare, lifestyle behaviors, and environmental exposures. The majority of the studies were observational and had some limitations, such as possible confounding factors and lack of generalizability.

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Conclusion: This study highlights the need for more research to understand the relationship between SES and CKD, and to identify strategies for reducing these disparities. The results of our meta-analysis suggest that socioeconomic disparities in CKD are a major public health concern and further studies is needed to develop targeted interventions to reduce these disparities and improve health outcomes for vulnerable populations. The potential mechanisms and modifiable risk factors identified in this study could be a starting point for future research in this area.