Socioeconomic disadvantage and kidney disease in the United States, Australia, and Thailand.
OBJECTIVE
We sought to determine whether an elevated burden of chronic kidney disease is found among disadvantaged groups living in the United States, Australia, and Thailand.


METHODS
We used data on participants 35 years or older for whom a valid serum creatinine measurement was available from studies in the United States, Thailand, and Australia. We used logistic regression to analyze the association of income, education, and employment with the prevalence of chronic kidney disease (estimated glomerular filtration rate<60 mL/min/1.73 m(2)).


RESULTS
Age- and gender-adjusted odds of having chronic kidney disease were increased 86% for US Whites in the lowest income quartile versus the highest quartile (odds ratio [OR] = 1.86; 95% confidence interval [CI] = 1.27, 2.72). Odds were increased 2 times and 6 times, respectively, among unemployed (not retired) versus employed non-Hispanic Black and Mexican American participants (OR=2.89; 95% CI=1.53, 5.46; OR=6.62; 95% CI=1.94, 22.64. respectively). Similar associations were not evident for the Australian or Thai populations.


CONCLUSIONS
Higher kidney disease prevalence among financially disadvantaged groups in the United States should be considered when chronic kidney disease prevention and management strategies are created. This approach is less likely to be of benefit to the Australian and Thai populations.
George Institute, Sydney, NSW, Australia. swhite@george.org.au
Sarah L
SL
White
Kevin
K
McGeechan
Michael
M
Jones
Alan
A
Cass
Steven J
SJ
Chadban
Kevan R
KR
Polkinghorne
Vlado
V
Perkovic
Paul J
PJ
Roderick
D001315:Australia / Q000453:epidemiology; D016001:Confidence Intervals; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000517:prevention & control; D017057:Medically Uninsured / Q000706:statistics & numerical data*; D008913:Minority Groups / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D016017:Odds Ratio; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D011322:Primary Prevention / Q000706:statistics & numerical data*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013785:Thailand / Q000453:epidemiology; D014481:United States / Q000453:epidemiology