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Abstract: TH-PO439

Association Between Income Disparities and Risk of CKD: A Nationwide Cohort Study of 7 Million Adults in Korea

Session Information

Category: CKD (Non-Dialysis)

  • 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Kang, Shin-Wook, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Jung, Chan-Young, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Ko, Byounghwi, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Jo, Wonji, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Korea (the Republic of)
  • Chang, Tae ik, National Health Insurance Service Medical Center, Ilsan Hospital, Gyunggi-do, Korea (the Republic of)
Background

Income disparities may have bearing on public health problems. However, longitudinal studies of the relationship between income level and incident chronic kidney disease (CKD) are scarce.

Methods

To examine the association between income level and incident CKD in healthy adults with normal baseline kidney function, we studied the association between income level categorized into deciles and incident CKD in a national cohort comprised of 7.4 million adults who underwent National Health Insurance Service health examinations between 2009−2015 with baseline estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73m2. Incident CKD was defined as de novo development of eGFR <60 mL/min per 1.73m2 (model 1) or ≥25% decline in eGFR from the baseline values accompanied by eGFR <60 mL/min/1.73m2 (model 2).

Results

During a median follow-up of 4.8 years, there were a total of 122,032 (1.65%) and 55,779 (0.75%) incident CKD events based on model 1 and 2 definitions, respectively. Compared with income levels in the sixth decile, there was an inverse association between lower income level and higher risk of CKD up to fourth decile, above which no additional reduction (model 1) or slightly higher risk of CKD (model 2) was observed at higher income levels. The multivariable-adjusted hazard ratios (95% confidence interval) from the lowest to fourth deciles were 1.30 (1.26-1.33), 1.16 (1.13-1.19), 1.07 (1.05-1.10), and 1.06 (1.03-1.09) in model 1 and 1.32 (1.27-1.37), 1.18 (1.14-1.22), 1.08 (1.04-1.13), and 1.05 (1.01-1.09) in model 2, respectively. These associations persisted across various subgroups of age, sex, and comorbidity status.

Conclusion

In this large nationwide cohort, lower income levels were associated with higher risk of incident CKD.