title: Socio-economic disparities in the distribution of cardiovascular risk in chronic kidney disease stage 3.
abstract: OBJECTIVE
  For most people with chronic kidney disease (CKD), cardiovascular disease (CVD) risk exceeds risk of progression to end-stage renal disease. This study aimed to investigate the distribution of cardiovascular risk in CKD stage 3 by socio-economic status (SES; measured by area deprivation and educational attainment) and CKD diagnosis awareness.
  
  
  METHODS
  1,741 patients with CKD 3 recruited from primary-care practices for the Renal Risk in Derby Study were assessed for cardiovascular risk factors. Ten-year cardiovascular risk, estimated using Framingham and QRISK2 risk prediction algorithms in eligible subgroups, was dichotomised at ≥ 20% (a threshold for clinical action in the UK), and compared by SES and awareness of CKD diagnosis using logistic regression.
  
  
  RESULTS
  Patients with lower SES had greater adjusted odd ratios (OR) of smoking, diabetes and previous CVD, but not of central obesity, hypertension, elevated total/high-density-lipoprotein cholesterol ratio or albuminuria. Using Framingham scoring (n = 672), the adjusted OR of having ≥ 20% 10-year risk were 2.87 [95% confidence interval (CI) 1.41-5.84] in the lowest deprivation quintile compared to the highest, 2.52 (95% CI: 1.52-4.00) in those without qualifications compared to those with qualifications, and 1.54 (95% CI: 1.09-2.17) in those unaware of their CKD diagnosis compared to those aware of it. QRISK2 scoring (n = 1,071) showed a similar association with education status [OR: 2.45 (95% CI: 1.63-3.67)] and lack of CKD awareness [OR: 1.46 (95% CI: 1.05-2.03)], but not with deprivation [OR: 1.12 (95% CI: 0.55-2.27)].
  
  
  CONCLUSIONS
  An elevated CVD risk is associated with a lower education status and lack of awareness of CKD diagnosis in people with CKD 3.
authors.affiliation: Public Health Sciences and Medical Statistics, University of Southampton, Southampton, UK. s.fraser @ soton.ac.uk
authors.forename: Simon D S
authors.initials: SD
authors.lastname: Fraser
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Roderick
authors.forename: Natasha J
authors.initials: NJ
authors.lastname: McIntyre
authors.forename: Scott
authors.initials: S
authors.lastname: Harris
authors.forename: Christopher W
authors.initials: CW
authors.lastname: McIntyre
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Fluck
authors.forename: Maarten W
authors.initials: MW
authors.lastname: Taal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors; D012959:Socioeconomic Factors