title: Socioeconomic disparities in chronic kidney disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  Evidence on the strength of the association between low SES and chronic kidney disease (CKD; measured by low estimated glomerular filtration rate [eGFR], high albuminuria, low eGFR/high albuminuria, and renal failure) is scattered and sometimes conflicting. Therefore, a systematic review and meta-analysis was performed to summarize the strength of the associations between SES and CKD and identify study-level characteristics related to this association.
  
  
  METHODS
  Studies published through January 2013 in MEDLINE and Embase were searched. From 35 studies that met the inclusion criteria, association estimates were pooled per CKD measure in the meta-analysis (performed between 2013 and 2014). Meta-regression analysis was used to identify study-level characteristics related to the strength of the SES-CKD association.
  
  
  RESULTS
  Low SES was associated with low eGFR (OR=1.41, 95% CI=1.21, 1.62), high albuminuria (OR=1.52, 95% CI=1.22, 1.82), low eGFR/high albuminuria (OR=1.38, 95% CI=1.03, 1.74), and renal failure (OR=1.55, 95% CI=1.40, 1.71). Differences in SES measures across studies were not related to the strength of associations between low SES and any of the CKD measures (low GFR, p=0.63; high albuminuria, p=0.29; low eGFR/high albuminuria, p=0.54; renal failure, p=0.31). Variations in the strength of associations were related to the level of covariate adjustment for low eGFR (p<0.001) and high albuminuria (p<0.001).
  
  
  CONCLUSIONS
  Socioeconomic disparities in CKD were fairly strong, irrespective of how SES was measured. Variations in the strength of the associations were related to the level of covariate adjustment, particularly for low eGFR and high albuminuria.
authors.affiliation: Department of Health Sciences, Community and Occupational Medicine. Electronic address: p.vart@umcg.nl.
authors.forename: Priya
authors.initials: P
authors.lastname: Vart
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Ron T
authors.initials: RT
authors.lastname: Gansevoort
authors.affiliation: Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Beth Israel Deaconess Medical Center, Boston, Massachusetts.
authors.forename: Michel M
authors.initials: MM
authors.lastname: Joosten
authors.affiliation: Department of Health Sciences, Community and Occupational Medicine.
authors.forename: Ute
authors.initials: U
authors.lastname: Bültmann
authors.affiliation: Department of Health Sciences, Community and Occupational Medicine.
authors.forename: Sijmen A
authors.initials: SA
authors.lastname: Reijneveld
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012923:Social Class; D014481:United States / Q000453:epidemiology; D055815:Young Adult