Abstract: SA-PO849
Association of Educational Attainment with Incidence of CKD: Coronary Artery Risk Development in Young Adults (CARDIA) Study
Session Information
- CKD: Socioeconomic Context and Mobile Apps
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Tripathy, Swetapadma, Northwestern University feinberg school of medicine, Chicago, Illinois, United States
- Cai, Xuan, Northwestern University, Chicago, Illinois, United States
- Peralta, Carmen A., Cricket Health, UCSF, San Francisco, California, United States
- Kramer, Holly J., Loyola University Medical Center, Maywood, Illinois, United States
- Jacobs, David R., University of Minnesota School of Public Health, Minneapolis, Minnesota, United States
- Isakova, Tamara, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
Background
Chronic kidney disease (CKD) is a major public health challenge that is greatly impacted by social determinants of health, including education. There are limited data on relationship of low educational attainment with incidence of CKD in young adults.
Methods
We evaluated the association of education with incident CKD and with change in estimated glomerular filtration rate (eGFR) over 20 years in 3140 participants of the Coronary Artery Risk Development in Young Adults (CARDIA) Study. We categorized education into low (high school and below), medium (college), and high (masters and professional studies) groups. Incident CKD was defined as new development of estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2, or urine albumin to creatinine ratio (ACR) ≥ 30 mg/g.
Results
At baseline (year-10 study visit), mean age was 35 ± 3.6 years, mean eGFR was 110.2 ± 16.0 ml/min/1.73m2, and median ACR was 3.9 (interquartile range, 2.7 – 5.9) mg/g. Participants with lower educational attainment were less likely to have health care access and engage in healthy lifestyle, and had more comorbidities. Over 20 years, 407 participants (13%) developed CKD. Compared to individuals with low educational attainment, those with medium educational attainment had an unadjusted hazard ratio (HR) for CKD of 0.79 (95% confidence intervals [CI] 0.65 – 0.97) and those with high educational attainment had a HR of 0.44 (95%CI 0.30 – 0.63). This association was no longer significant after adjusting for health care access, lifestyle, and comorbid conditions. Low educational attainment remained significantly associated with change in eGFR, although the relationship was attenuated with adjustment for covariates.
Conclusion
Health care access, lifestyle, and comorbid conditions likely help explain the association between low educational attainment and incident CKD in young adults.