title: Predictors of end-stage renal disease in the urban poor.
abstract: We sought to examine the influence of social and clinical factors on risk of progression of chronic kidney disease (CKD) to end-stage renal disease (ESRD) in the urban poor. We studied 15,353 individuals with moderate-to-advanced CKD who received ambulatory care within a large public health system during 1996-2005. The primary outcome was progression to ESRD. Overall, 559 cases of ESRD occurred over a median follow-up of 2.8 years. Among traditional predictors of ESRD, younger age, male sex, non-White race/ethnicity, public health insurance coverage, diabetes, lower kidney function, higher proteinuria, lower hemoglobin level, and lower serum albumin concentration were significantly associated with a higher adjusted ESRD risk (p&lt;.001 for all). There was no significant association between HIV/AIDS (p=.07), viral hepatitis (p=.11), or non-English language (p=.27) and ESRD risk. Our results highlight the importance of addressing traditional risk factors for progressive CKD to reduce the disproportionate burden of ESRD among disadvantaged populations.
authors.forename: Yoshio N
authors.initials: YN
authors.lastname: Hall
authors.forename: Andy I
authors.initials: AI
authors.lastname: Choi
authors.forename: Ping
authors.initials: P
authors.lastname: Xu
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Smith
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011203:Poverty; D012189:Retrospective Studies; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D014505:Urban Population