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BMC Nephrology
Published in: BMC Nephrology 1/2018

Open Access 01-12-2018 | Research article

The association between socioeconomic disparities and left ventricular hypertrophy in chronic kidney disease: results from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD)

Authors: Eunjeong Kang, Joongyub Lee, Hyo Jin Kim, Miyeun Han, Soo Wan Kim, Kyu-Beck Lee, Suah Sung, Tae-Hyun Yoo, Wookyung Chung, Curie Ahn, Kook-Hwan Oh

Published in: BMC Nephrology | Issue 1/2018

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Abstract

Background

Left ventricular hypertrophy (LVH) is one of the risk factors for cardiovascular (CV) disease and mortality. However, the relationship between socioeconomic status (SES) and LVH in chronic kidney disease remains unclear.

Methods

Data were collected from the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD, NCT01630486 at http://​www.​clinicaltrials.​gov). Subjects with CKD and aged ≥50 were included. SES was characterized based on monthly income and educational attainment, each of which was divided into three strata. LVH was defined as LV mass/height2.7 ≥ 47 g/m2.7 in female and ≥ 50 g/m2.7 in male. Age, sex, diabetes, CKD stage, body mass index, blood pressure and physical activity were included as covariates.

Results

A total of 1361 patients were included. Mean age was 60.9 ± 6.9 years, and 63.2% were men. Higher education level was associated with higher monthly income (P for trend < 0.001). The lowest education level was independently associated with LVH (lower than high school, adjusted odds ratio [OR] 1.485, 95% CI 1.069–2.063, P = 0.018; completed high school, adjusted OR 1.150, 95% confidence interval [CI] 0.834–1.584, P = 0.394; highest education level as the reference). Monthly income level was marginally associated with LVH after adjusting for covariates ($1500-4500, adjusted OR 1.230, 95% CI 0.866–1.748, P = 0.247; < $1500, adjusted OR 1.471, 95% CI 1.002–2.158, P = 0.049; > $4500; reference).

Conclusions

In the CKD population, lower SES, defined by educational attainment and low income level exhibited a significant association with LVH, respectively. Longitudinal follow-up will reveal whether lower SES is associated with poor CKD outcomes.
Literature
1.
Adler NE, Boyce WT, Chesney MA, Folkman S, Syme SL. Socioeconomic inequalities in health. No easy solution. Jama. 1993;269(24):3140–5.CrossRefPubMed
2.
Adler NE, Ostrove JM. Socioeconomic status and health: what we know and what we don't. Ann N Y Acad Sci. 1999;896:3–15.CrossRefPubMed
3.
Marmot MG, Rose G, Shipley M, Hamilton PJ. Employment grade and coronary heart disease in British civil servants. J Epidemiol Community Health. 1978;32(4):244–9.CrossRefPubMedPubMedCentral
4.
5.
Choi AI, Weekley CC, Chen SC, Li S, Tamura MK, Norris KC, Shlipak MG. Association of educational attainment with chronic disease and mortality: the kidney early evaluation program (KEEP). Am J Kidney Dis. 2011;58(2):228–34.CrossRefPubMedPubMedCentral
6.
Meadows P. Variation of diabetes mellitus prevalence in general practice and its relation to deprivation. Diabet Med. 1995;12(8):696–700.CrossRefPubMed
7.
Berg JW, Ross R, Latourette HB. Economic status and survival of cancer patients. Cancer. 1977;39(2):467–77.CrossRefPubMed
8.
Bradley CJ, Given CW, Roberts C. Race, socioeconomic status, and breast cancer treatment and survival. J Natl Cancer Inst. 2002;94(7):490–6.CrossRefPubMed
9.
Bello AK, Peters J, Rigby J, Rahman AA, El Nahas M. Socioeconomic status and chronic kidney disease at presentation to a renal service in the United Kingdom. Clin J Am Soc Nephrol. 2008;3(5):1316–23.CrossRefPubMedPubMedCentral
10.
Norton JM, Moxey-Mims MM, Eggers PW, Narva AS, Star RA, Kimmel PL, Rodgers GP. Social determinants of racial disparities in CKD. J Am Soc Nephrol. 2016;27(9):2576–95.
11.
12.
Middleton RJ, Parfrey PS, Foley RN. Left ventricular hypertrophy in the renal patient. J Am Soc Nephrol. 2001;12(5):1079–84.PubMed
13.
Parfrey PS, Foley RN, Harnett JD, Kent GM, Murray DC, Barre PE. Outcome and risk factors for left ventricular disorders in chronic uraemia. Nephrol Dial Transplant. 1996;11(7):1277–85.CrossRefPubMed
14.
Rodriguez CJ, Sciacca RR, Diez-Roux AV, Boden-Albala B, Sacco RL, Homma S, DiTullio MR. Relation between socioeconomic status, race-ethnicity, and left ventricular mass: the northern Manhattan study. Hypertension. 2004;43(4):775–9.CrossRefPubMedPubMedCentral
15.
Oh KH, Park SK, Park HC, Chin HJ, Chae DW, Choi KH, Han SH, Yoo TH, Lee K, Kim YS, et al. KNOW-CKD (KoreaN cohort study for outcome in patients with chronic kidney disease): design and methods. BMC Nephrol. 2014;15:80.CrossRefPubMedPubMedCentral
16.
Levey AS, Stevens LA, Schmid CH, Zhang YL, Castro AF 3rd, Feldman HI, Kusek JW, Eggers P, Van Lente F, Greene T, et al. A new equation to estimate glomerular filtration rate. Ann Intern Med. 2009;150(9):604–12.CrossRefPubMedPubMedCentral
17.
Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, Pellikka PA, Picard MH, Roman MJ, Seward J, Shanewise JS, et al. Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology. J Am Soc Echocardiogr. 2005;18(12):1440–63.CrossRefPubMed
18.
de Simone G, Devereux RB, Daniels SR, Koren MJ, Meyer RA, Laragh JH. Effect of growth on variability of left ventricular mass: assessment of allometric signals in adults and children and their capacity to predict cardiovascular risk. J Am Coll Cardiol. 1995;25(5):1056–62.CrossRefPubMed
19.
Glassock RJ, Pecoits-Filho R, Barberato SH. Left ventricular mass in chronic kidney disease and ESRD. Clin J Am Soc Nephrol. 2009;4(Suppl 1):S79–91.CrossRefPubMed
20.
21.
22.
Vart P, Gansevoort RT, Crews DC, Reijneveld SA, Bultmann U. Mediators of the association between low socioeconomic status and chronic kidney disease in the United States. Am J Epidemiol. 2015;181(6):385–96.CrossRefPubMedPubMedCentral
23.
Kim DH, Kim M, Kim H, Kim YL, Kang SW, Yang CW, Kim NH, Kim YS, Lee JP. Early referral to a nephrologist improved patient survival: prospective cohort study for end-stage renal disease in Korea. PLoS One. 2013;8(1):e55323.CrossRefPubMedPubMedCentral
24.
Wavamunno MD, Harris DC. The need for early nephrology referral. Kidney Int Suppl. 2005;94:S128–32.CrossRef
25.
Moon S, Shin J. Performance of universal health insurance: lessons from South Korea. World Health Popul. 2007;9(2):95–113.CrossRefPubMed
26.
Liaropoulos LL. Health services financing in Greece: a role for private health insurance. Health Policy. 1995;34(1):53–62.CrossRefPubMed
27.
Kwon S, Reich MR. The changing process and politics of health policy in Korea. J Health Polit Policy Law. 2005;30(6):1003–26.CrossRefPubMed
28.
Shin J. Private health insurance in South Korea: an international comparison. Health Policy. 2012;108(1):76–85.CrossRefPubMed
29.
Selye H. The Stess of Life. New York: McGraw-Hill; 1956.
30.
Theorell T, Karasek RA. Current issues relating to psychosocial job strain and cardiovascular disease research. J Occup Health Psychol. 1996;1(1):9–26.CrossRefPubMed
31.
32.
Everson-Rose SA, Lewis TT. Psychosocial factors and cardiovascular diseases. Annu Rev Public Health. 2005;26:469–500.CrossRefPubMed
33.
Sternberg EM, Chrousos GP, Wilder RL, Gold PW. The stress response and the regulation of inflammatory disease. Ann Intern Med. 1992;117(10):854–66.CrossRefPubMed
34.
Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress. Does stress account for SES effects on health? Ann N Y Acad Sci. 1999;896:131–44.CrossRefPubMed
35.
Rapaport E. Pathophysiological basis of ventricular hypertrophy. Eur Heart J. 1982;3 Suppl A:29–33.CrossRefPubMed
36.
Cukor D, Cohen SD, Peterson RA, Kimmel PL. Psychosocial aspects of chronic disease: ESRD as a paradigmatic illness. J Am Soc Nephrol. 2007;18(12):3042–55.CrossRefPubMed
37.
de Simone G, Devereux RB, Roman MJ, Schlussel Y, Alderman MH, Laragh JH. Echocardiographic left ventricular mass and electrolyte intake predict arterial hypertension. Ann Intern Med. 1991;114(3):202–9.CrossRefPubMed
38.
Vlismas K, Stavrinos V, Panagiotakos DB. Socio-economic status, dietary habits and health-related outcomes in various parts of the world: a review. Cent Eur J Public Health. 2009;17(2):55–63.CrossRefPubMed
39.
Darmon N, Drewnowski A. Does social class predict diet quality? Am J Clin Nutr. 2008;87(5):1107–17.CrossRefPubMed
40.
41.
Tian HG, Hu G, Dong QN, Yang XL, Nan Y, Pietinen P, Nissinen A. Dietary sodium and potassium, socioeconomic status and blood pressure in a Chinese population. Appetite. 1996;26(3):235–46.CrossRefPubMed
42.
Ortega RM, Lopez-Sobaler AM, Ballesteros JM, Perez-Farinos N, Rodriguez-Rodriguez E, Aparicio A, Perea JM, Andres P. Estimation of salt intake by 24 h urinary sodium excretion in a representative sample of Spanish adults. Br J Nutr. 2011;105(5):787–94.CrossRefPubMed
43.
Ribic CH, Zakotnik JM, Vertnik L, Vegnuti M, Cappuccio FP. Salt intake of the Slovene population assessed by 24 h urinary sodium excretion. Public Health Nutr. 2010;13(11):1803–9.CrossRefPubMed
44.
Organization WH. Diet, nutrition and the prevention of chronic diseases (WHO technical report series, no. 916). Geneva: World Health Organization Press; 2003.
45.
46.
Parfrey PS, Foley RN. The clinical epidemiology of cardiac disease in chronic renal failure. J Am Soc Nephrol. 1999;10(7):1606–15.PubMed
47.
Astor BC, Arnett DK, Brown A, Coresh J. Association of kidney function and hemoglobin with left ventricular morphology among African Americans: the atherosclerosis risk in communities (ARIC) study. Am J Kidney Dis. 2004;43(5):836–45.CrossRefPubMed
48.
Kim JY, Shin S, Han K, Lee KC, Kim JH, Choi YS, Kim DH, Nam GE, Yeo HD, Lee HG, et al. Relationship between socioeconomic status and anemia prevalence in adolescent girls based on the fourth and fifth Korea National Health and nutrition examination surveys. Eur J Clin Nutr. 2014;68(2):253–8.CrossRefPubMed
49.
Nguyen PH, Gonzalez-Casanova I, Nguyen H, Pham H, Truong TV, Nguyen S, Martorell R, Ramakrishnan U. Multicausal etiology of anemia among women of reproductive age in Vietnam. Eur J Clin Nutr. 2015;69(1):107–13.CrossRefPubMed
50.
Shimakawa T, Sorlie P, Carpenter MA, Dennis B, Tell GS, Watson R, Williams OD. Dietary intake patterns and sociodemographic factors in the atherosclerosis risk in communities study. ARIC study investigators. Prev Med. 1994;23(6):769–80.CrossRefPubMed
51.
Hulshof KF, Brussaard JH, Kruizinga AG, Telman J, Lowik MR. Socio-economic status, dietary intake and 10 y trends: the Dutch National Food Consumption Survey. Eur J Clin Nutr. 2003;57(1):128–37.CrossRefPubMed
Metadata
Title
The association between socioeconomic disparities and left ventricular hypertrophy in chronic kidney disease: results from the KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD)
Authors
Eunjeong Kang
Joongyub Lee
Hyo Jin Kim
Miyeun Han
Soo Wan Kim
Kyu-Beck Lee
Suah Sung
Tae-Hyun Yoo
Wookyung Chung
Curie Ahn
Kook-Hwan Oh
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2018
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-018-1005-3

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