Kidney Week

Abstract: TH-PO1080

Association Between Religiosity and Risk of End-Stage Kidney Disease (ESKD) Among Blacks and Whites in the Southeastern United States

Session Information

• CKD: Epidemiology, Risk Factors, Prevention - I
  October 25, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Nair, Devika, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Devika Nair,

• Cavanaugh, Kerri L., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Kerri L. Cavanaugh,

• Wallston, Ken, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Ken Wallston,

• Bian, Aihua, Vanderbilt University, Nashville, Tennessee, United States

Aihua Bian,

• Stewart, Thomas G., Vanderbilt University Medical Center, Nashville, Tennessee, United States

Thomas G. Stewart,

• Blot, William J., Vanderbilt University Medical Center, Nashville, Tennessee, United States

William J. Blot,

• Ikizler, Talat Alp, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Talat Alp Ikizler,

• Lipworth, Loren, Vanderbilt University Medical Center, Nashville, Tennessee, United States

Loren Lipworth,

Background

Religiosity is associated with improved outcomes in chronic illnesses via healthy behaviors and is prevalent among blacks as a means to cope with health-related stress. No study of religiosity in kidney disease has examined its association with objective measures of physical health such as progression to ESKD.

Methods

The Southern Community Cohort Study is a large prospective cohort of low socioeconomic status blacks and whites in the southeastern U.S. Using a case-cohort design, we examined the association between religiosity and ESKD among 737 incident ESKD cases ascertained by USRDS linkage and a probability sampled subcohort (n=4,238). Religiosity was recorded at enrollment via three self-reported items: frequency of church service attendance; degree of spirituality; and degree of comfort from religion. We constructed Cox regression models, accounting for sampling weights, of time to ESKD in relation to each religiosity item, and adjusted for demographic, psychosocial (social support, depressive symptoms), and clinical variables (including diabetes, hypertension, estimated glomerular filtration rate). Interaction between each religiosity item and race was statistically significant (p<0.01).

Results

Overall, 24% of blacks, compared to 18% of whites, reported the highest frequency of service attendance (>once/week); 57% and 72% of blacks reported very high spirituality and high degree of comfort from religion, respectively, compared to 51% and 56% of whites. Among blacks, hazard ratios (HR) and 95% confidence intervals (CI) for ESKD associated with the highest vs. lowest categories of service attendance, spirituality, and comfort from religion were 0.74 (0.57-0.97), 0.66 (0.54 to 0.80), and 0.23 (0.15-0.36), respectively. Among whites, the corresponding estimates were 0.28 (0.16-0.50), 1.08 (0.66-1.77), and 1.11 (0.44-2.78).

Conclusion

Frequent attendance at religious services is associated with a decreased risk for ESKD among socioeconomically-disadvantaged black and white adults. Among blacks, spirituality and comfort from religion are also associated with decreased ESKD risk. Engaging blacks in faith-based community settings may be a culturally-relevant way to facilitate healthy behaviors to decrease kidney disease progression.

Funding

• NIDDK Support