title: End stage renal disease risk and neighbourhood deprivation: a nationwide cohort study in Sweden.
abstract: BACKGROUND
  Chronic kidney disease has been associated with socioeconomic disparities and neighbourhood deprivation. We aimed to determine whether there is an association between neighbourhood deprivation and end stage renal disease (ESRD), and whether this association is independent of individual-level sociodemographic factors and comorbidities.
  
  
  METHODS
  National Swedish data registers were used. The entire Swedish population aged 20-69 years was followed from January 1, 2001 until December 31, 2010. Data were analysed by multilevel logistic regression, with individual-level sociodemographic factors (age, marital status, family income, education level, country of birth, urban/rural status, and mobility) and comorbidities at the first level and neighbourhood deprivation at the second level.
  
  
  RESULTS
  Neighbourhood deprivation was significantly associated with ESRD (age-adjusted odds ratio [OR] 1.45, 95% confidence interval [CI] 1.34-1.56 in men and OR 1.59, 95% CI 1.44-1.75 in women). The ORs for ESRD in men and women living in the most deprived neighbourhoods remained significantly increased when adjusted for age and individual-level sociodemographic factors (OR 1.25, 95% CI 1.15-1.35 in men and OR 1.30, 95% CI 1.17-1.44 in women). In the full model, which took account of sociodemographic factors and comorbidities, the ORs for ESRD remained significantly increased (OR 1.17, 95% CI 1.07-1.27 in men and OR 1.18, 95% CI 1.06-1.31 in women).
  
  
  CONCLUSIONS
  Neighbourhood deprivation is independently associated with ESRD in both men and women irrespective of individual-level sociodemographic factors and comorbidities.
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden. Electronic address: delshad.akrawi@med.lu.se.
authors.forename: Delshad Saleh
authors.initials: DS
authors.lastname: Akrawi
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
authors.forename: Xinjun
authors.initials: X
authors.lastname: Li
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States.
authors.forename: Jan
authors.initials: J
authors.lastname: Sundquist
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States.
authors.forename: Kristina
authors.initials: K
authors.lastname: Sundquist
authors.affiliation: Center for Primary Health Care Research, Lund University/Region Skåne, Malmö, Sweden.
authors.forename: Bengt
authors.initials: B
authors.lastname: Zöller
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011203:Poverty / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
keywords: End stage renal disease; Neighbourhood deprivation; Risk factors; Socioeconomic factors