Kidney Week

Abstract: TH-PO532

Disadvantaged Childhood Socioeconomic Position Represents a Critical Period for the Embedding of Kidney Disease Risk in Women

Session Information

• CKD: Health Services, Disparities, Prevention
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 307 CKD: Health Services, Disparities, Prevention

Authors

• Canney, Mark, Trinity College Dublin, Dublin, Ireland

Mark Canney,

• Leahy, Siobhan, Trinity College Dublin, Dublin, Ireland

Siobhan Leahy,

• Scarlett, Siobhan, Trinity College Dublin, Dublin, Ireland

Siobhan Scarlett,

• Kenny, Rose Anne M., Trinity College Dublin, Dublin, Ireland

Rose Anne M. Kenny,

• Little, Mark Alan, Trinity College Dublin, Dublin, Ireland

Mark Alan Little,

• O'Seaghdha, Conall M., Beaumont Hospital, Dublin, Ireland

Conall M. O'Seaghdha,

• McCrory, Cathal, Trinity College Dublin, Dublin, Ireland

Cathal McCrory,

Background

Socioeconomic position (SEP) is an important determinant of health but is dynamic across the lifespan. This study examines the relationship between life course SEP and chronic kidney disease (CKD) using three conceptual life course models: critical period, pathway and accumulation. We test each model in a population of Irish adults who experienced dramatic social mobility during their lifetime, as Ireland transitioned rapidly from a primarily agricultural to post-industrial society.

Methods

Cross-sectional analysis of data from 4996 participants from The Irish Longitudinal Study on Ageing, a nationally representative sample of community-dwelling adults aged ≥50 years. We defined CKD as a glomerular filtration rate <60mL/min/1.73m² estimated from the combination of creatinine and cystatin C using the CKD-EPI formula. We defined childhood and adulthood SEP according to father’s and respondent’s occupation respectively, and categorised SEP as high (reference), intermediate, low or never worked. We tested the critical period and pathway models by examining the age-adjusted relationship between SEP and CKD using logistic regression separately in men and women. We tested the accumulation model by fitting an interaction between childhood and adulthood SEP, and assessed social mobility trajectories arising from that interaction.

Results

Low childhood SEP was strongly associated with CKD in women, even after adjusting for adulthood SEP (odds ratio 1.90 [95% confidence interval 1.24, 2.92]), supporting the critical period over the pathway hypothesis. This association was not explained by traditional CKD risk factors including central obesity, diabetes, smoking or hypertension. Women who experienced low childhood SEP and whose circumstances improved in adulthood also had increased odds of CKD, further supporting a critical period effect in childhood. The interaction between childhood and adulthood SEP was not statistically significant in either sex. We did not observe any substantive association between SEP and CKD in men.

Conclusion

Our findings suggest that women exposed to disadvantaged SEP in childhood represent an at-risk group in whom there may be opportunities for identification of CKD and facilitation of health-promoting behaviours from an early age.

Funding

• Government Support - Non-U.S.