Abstract: TH-PO1046
Impact of Longitudinal Income Change on Risk of ESKD in CKD: A Population-Based Cohort Study
Session Information
- CKD: Epidemiology, Risk Factors, and Other Conditions
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Lee, Jinsun, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea (the Republic of)
- Park, Sehoon, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
- Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, Seoul, Korea (the Republic of)
- Han, Kyungdo, Soongsil University, Dongjak-gu, Seoul, Korea (the Republic of)
- Kang, Min Woo, Korea University Guro Hospital, Guro-gu, Seoul, Korea (the Republic of)
Background
Studies analyzing the association between income changes and incident end-stage kidney disease(ESKD) in individuals with chronic kidney disease(CKD) are limited.
Methods
Using data from the Korean National Health Insurance Service, 1,296,876 adults aged 30-64 with CKD and no history of ESKD were identified among those who underwent health checkups from 2012 to 2017. Annual income from the baseline and four preceding years was collected and classified into quartiles and medical aid status. Income parameters included cumulative number of years being in high or low income group, income volatility, and change in income status between two time points. The primary outcome was incident ESKD, followed up until December 31, 2022. Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals. Stratified analyses and interaction tests were conducted.
Results
A total of 28,924 incident ESKD cases were identified over a mean follow-up of 7.76 ± 1.57 years. Individuals with more persistent high income status had a lower risk of ESKD (HR 5years vs 0years 0.81, 95% CI 0.79-0.84; P for trend<.001). Higher income volatility was associated with a higher risk of ESKD (HR Q4 vs Q1 1.26, 95% CI 1.22-1.30; P for trend<.001). Additionally, individuals with a decline in income had a higher risk of ESKD, whereas those with an increase had a lower risk. The association between persistent income status and ESKD risk was stronger in individuals younger than 50 years, male, obese, or without baseline hypertension.
Conclusion
Among adults aged 30–64 with CKD, persistent high income status was associated with a lower risk of ESKD, whereas high income volatility or income decline was associated with a higher risk. The association was pronounced among those younger than 50 years, male, obese, or without baseline hypertension.
Funding
- Government Support – Non-U.S.