Effect of community characteristics on familial clustering of end-stage renal disease.
BACKGROUND
Lower socioeconomic status is generally associated with an increased risk of end-stage renal disease (ESRD). The relationship between community characteristics reflecting socioeconomic status and familial aggregation of common forms of ESRD has not been studied.


METHODS
Demographic data and family history of ESRD were collected from 23,880 incident dialysis patients in ESRD Network 6 between 1995 and 2003. Addresses were geocoded and linked to the 2000 census 5-digit zip code-level database that includes community demographic, social and economic characteristics. Clustering of patients having a family history of ESRD at the community level was accounted for using a generalized estimating equations (GEE) model. Multivariate analysis estimated associations between family history of ESRD and community-level characteristics.


RESULTS
Twenty-three percent of patients reported a family history of ESRD. After adjusting for individual demographic characteristics, multivariate analyses failed to reveal statistically significant relationships between a family history of ESRD and indicators of community socioeconomic status such as median household income, percentage high school graduates, percentage vacant housing units or ethnic composition.


CONCLUSIONS
Although select community measures of lower socioeconomic status may contribute to the familial clustering of ESRD, non-socioeconomic factors, potentially inherited, appear to be more important contributors to familial aggregation of the common forms of ESRD.
Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, N.C. 27157-1053, USA.
Eun-Young
EY
Song
William M
WM
McClellan
Ann
A
McClellan
Rajyalakshmi
R
Gadi
Alexander C
AC
Hadley
Jenna
J
Krisher
Margo
M
Clay
Barry I
BI
Freedman
D000368:Aged; D019352:Censuses; D016000:Cluster Analysis; D016208:Databases, Factual; D004522:Educational Status; D005191:Family Characteristics; D005192:Family Health; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000453:epidemiology* / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012307:Risk Factors; D012923:Social Class