Abstract: FR-PO426

Lower School Educational Level Is Associated with Lower eGFR in Patients with Moderately Severe CKD: The GCKD Study

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Al-Fartwsi, Doris Christiane, University Hospital RWTH Aachen, Aachen, Germany
  • Meiselbach, Heike, University of Erlangen-Nuremberg, Erlangen, Germany
  • Kaesler, Nadine, University Hospital RWTH Aachen, Aachen, Germany
  • Ernst, Sabine, University Hospital RWTH Aachen, Aachen, Germany
  • Eckardt, Kai-Uwe, University of Erlangen-Nuremberg, Erlangen, Germany
  • Floege, Jürgen, University Hospital RWTH Aachen, Aachen, Germany
  • Schlieper, Georg, University Hospital RWTH Aachen, Aachen, Germany
  • Saritas, Turgay, University Hospital RWTH Aachen, Aachen, Germany
  • Schaeffner, Elke, Charité University Berlin, Berlin, Germany
  • Baid-Agrawal, Seema, Sahlgrenska University Hospital, University of Gothenburg, Gothenburrg, Sweden
  • Schmid, Matthias, University of Bonn, Bonn, Germany
  • Nadal, Jennifer, University of Bonn, Bonn, Germany
  • Schneider, Markus P., University of Erlangen-Nuremberg, Erlangen, Germany
  • Busch, Martin, University Hospital Jena, Jena, Germany
  • Wolf, MHBA, Gunter B., Jena University Hospital, Jena, Germany
  • Sommerer, Claudia, University Hospital of Heidelberg, Heidelberg, Germany

Group or Team Name

  • For GCKD investigators
Background

Low socioeconomic status (SES) is associated with increased prevalence of chronic kidney disease (CKD) and mortality. However, previous studies were mainly conducted in the U.S. population. This study evaluated the association between SES and kidney function in a large German cohort of patients with moderately severe CKD.

Methods

We analyzed data from 5111 patients of the German CKD (GCKD) study, who were enrolled on the basis of an eGFR of 30-60 mL/min or overt proteinuria. Patients were divided into three categories according to their school educational level: “low” (completed ≤ 9th grade), “intermediate” (10th grade) and “high” (≥12th grade). In addition, patients were stratified in four groups according to their annual household income: ≤25.000 €; 25.000 to <50.000 €; 50.000 to <100.000 €; ≥100.000 €. An ordinal logistic regression was run to determine the association of education and income on eGFR (<30, 30-44, 45-59, >60 mL/min) and urine albumin-to-creatinine ratio (UACR) (<30, 30-300, >300mg/g), adjusted for multiple confounders.

Results

In comparison with those who had high school education, patients with low education had lower eGFR (median eGFR 43 vs. 51 ml/min, p < 0.001). However, autoimmune disease was more prevalent and UACR was higher (median 78 vs. 48 mg/g) in patients with high education (p < 0.001). An association was also found between low education and low annual household income, and the prevalence of diabetes mellitus, hypertension, coronary heart disease, stroke, and arrhythmia (p < 0.001). Similar significant differences were observed by comparing patients with low income vs. high income. In multivariate analysis, the odds ratio of being in a lower category of eGFR for low educated vs. high-educated patients was 1.254 (95% CI: 1.077 - 1.459); p = 0.003. No significant association was found between income and eGFR levels. Furthermore, no association was found between education/income and UACR categories.

Conclusion

Within the GCKD cohort, low education level but not income was independently associated with lower eGFR. Furthermore, low education and low income were associated with a greater burden of comorbidities.

Funding

  • Private Foundation Support