title: The lack of income is associated with reduced survival in chronic haemodialysis.
abstract: BACKGROUND
  Poor socioeconomic status in the patient population is one of the causes of the lack of primary and secondary prevention of chronic kidney disease and negatively affects the survival of patients on chronic haemodialysis (HD).
  
  
  OBJECTIVE
  To confirm whether the low or absent income of the incident population on HD is a factor of poor prognosis.
  
  
  METHODS
  We used the incident HD population of the Argentine Registry of Chronic Dialysis. Follow-up lasted 12 months, performing an intention to treat analysis. We applied the Cox model to assess the association between income and survival of patients after adjusting for age, sex, diabetes, comorbidities, initial laboratory results, and first vascular access.
  
  
  RESULTS
  We analysed 13466 adult patients (age at onset: 60.4 ± 15.6 years; 57.2% were male, and 39.2% diabetic) who were assigned to 2 groups: 1) "no income" group, 5661 patients (age at onset: 60.3 ± 15.4 years; 53.1% were male and 41.4% diabetic), 2) "with income" group, 7805 patients (age at onset, 60.5 ± 15-8] years; 60.1% were male and 37.5% diabetic). The "no income" group had a hazard ratio of 1.19 (95% confidence interval [CI]: 1.11-1.28) in the univariate analysis, 1.23 (95% CI: 1.14-1.32 ) considering age and gender, 1.22 (95% CI: 1.13-1.31) by adding diabetes mellitus, 1.26 (95% CI: 1.18-1.36) by adding comorbidities, 1.25 (95% CI: 1.16- 1.35) by adding the initial laboratory results, and 1.24 (95% CI: 1.15- 1.33) if temporary vascular access is included. All models resulted in a significance of P=.000.
  
  
  CONCLUSIONS
  Low or no income of patients at the time of entry into HD is an independent risk factor for immediate lower survival.
authors.affiliation: Comité de Estadísticas y Registros, Sociedad Argentina de Nefrología, Ciudad Autónoma de Buenos Aires, Argentina. sergio.marinovich@gmail.com
authors.forename: Sergio
authors.initials: S
authors.lastname: Marinovich
authors.forename: Carlos
authors.initials: C
authors.lastname: Lavorato
authors.forename: Guillermo
authors.initials: G
authors.lastname: Rosa-Diez
authors.forename: Liliana
authors.initials: L
authors.lastname: Bisigniano
authors.forename: Víctor
authors.initials: V
authors.lastname: Fernández
authors.forename: Daniela
authors.initials: D
authors.lastname: Hansen-Krogh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis / Q000401:mortality*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D015996:Survival Rate