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Socio-economic disparities in the distribution of cardiovascular risk in chronic kidney disease stage 3

Socio-economic disparities in the distribution of cardiovascular risk in chronic kidney disease stage 3
Socio-economic disparities in the distribution of cardiovascular risk in chronic kidney disease stage 3
Background/Aims: For most people with chronic kidney disease (CKD), cardiovascular disease (CVD) risk exceeds risk of progression to end-stage renal disease. This study aimed to investigate the distribution of cardiovascular risk in CKD stage 3 by socio-economic status (SES; measured by area deprivation and educational attainment) and CKD diagnosis awareness.

Methods: 1,741 patients with CKD 3 recruited from primary-care practices for the Renal Risk in Derby Study were assessed for cardiovascular risk factors. Ten-year cardiovascular risk, estimated using Framingham and QRISK2 risk prediction algorithms in eligible subgroups, was dichotomised at ?20% (a threshold for clinical action in the UK), and compared by SES and awareness of CKD diagnosis using logistic regression.

Results: Patients with lower SES had greater adjusted odd ratios (OR) of smoking, diabetes and previous CVD, but not of central obesity, hypertension, elevated total/high-density-lipoprotein cholesterol ratio or albuminuria. Using Framingham scoring (n = 672), the adjusted OR of having ?20% 10-year risk were 2.87 [95% confidence interval (CI) 1.41-5.84] in the lowest deprivation quintile compared to the highest, 2.52 (95% CI: 1.52-4.00) in those without qualifications compared to those with qualifications, and 1.54 (95% CI: 1.09-2.17) in those unaware of their CKD diagnosis compared to those aware of it. QRISK2 scoring (n = 1,071) showed a similar association with education status [OR: 2.45 (95% CI: 1.63-3.67)] and lack of CKD awareness [OR: 1.46 (95% CI: 1.05-2.03)], but not with deprivation [OR: 1.12 (95% CI: 0.55-2.27)].

Conclusion: An elevated CVD risk is associated with a lower education status and lack of awareness of CKD diagnosis in people with CKD 3.
1660-8151
58-65
Fraser, Simon D.S.
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
McIntyre, Natasha J.
8d50caa9-9893-4f6c-9101-9207f5eaa331
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
McIntyre, Christopher W.
567b8ae4-b1dc-4792-bad0-f6dee73305d6
Fluck, Richard J.
fedcd5a4-5459-461f-bef0-3747f4a3757d
Taal, Maarten W.
10eeea62-a2fc-43b6-b5af-359e75c501ea
Fraser, Simon D.S.
135884b6-8737-4e8a-a98c-5d803ac7a2dc
Roderick, Paul J.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
McIntyre, Natasha J.
8d50caa9-9893-4f6c-9101-9207f5eaa331
Harris, Scott
19ea097b-df15-4f0f-be19-8ac42c190028
McIntyre, Christopher W.
567b8ae4-b1dc-4792-bad0-f6dee73305d6
Fluck, Richard J.
fedcd5a4-5459-461f-bef0-3747f4a3757d
Taal, Maarten W.
10eeea62-a2fc-43b6-b5af-359e75c501ea

Fraser, Simon D.S., Roderick, Paul J., McIntyre, Natasha J., Harris, Scott, McIntyre, Christopher W., Fluck, Richard J. and Taal, Maarten W. (2012) Socio-economic disparities in the distribution of cardiovascular risk in chronic kidney disease stage 3. Nephron Clinical Practice, 122 (1-2), 58-65. (doi:10.1159/000348835). (PMID:23548499)

Record type: Article

Abstract

Background/Aims: For most people with chronic kidney disease (CKD), cardiovascular disease (CVD) risk exceeds risk of progression to end-stage renal disease. This study aimed to investigate the distribution of cardiovascular risk in CKD stage 3 by socio-economic status (SES; measured by area deprivation and educational attainment) and CKD diagnosis awareness.

Methods: 1,741 patients with CKD 3 recruited from primary-care practices for the Renal Risk in Derby Study were assessed for cardiovascular risk factors. Ten-year cardiovascular risk, estimated using Framingham and QRISK2 risk prediction algorithms in eligible subgroups, was dichotomised at ?20% (a threshold for clinical action in the UK), and compared by SES and awareness of CKD diagnosis using logistic regression.

Results: Patients with lower SES had greater adjusted odd ratios (OR) of smoking, diabetes and previous CVD, but not of central obesity, hypertension, elevated total/high-density-lipoprotein cholesterol ratio or albuminuria. Using Framingham scoring (n = 672), the adjusted OR of having ?20% 10-year risk were 2.87 [95% confidence interval (CI) 1.41-5.84] in the lowest deprivation quintile compared to the highest, 2.52 (95% CI: 1.52-4.00) in those without qualifications compared to those with qualifications, and 1.54 (95% CI: 1.09-2.17) in those unaware of their CKD diagnosis compared to those aware of it. QRISK2 scoring (n = 1,071) showed a similar association with education status [OR: 2.45 (95% CI: 1.63-3.67)] and lack of CKD awareness [OR: 1.46 (95% CI: 1.05-2.03)], but not with deprivation [OR: 1.12 (95% CI: 0.55-2.27)].

Conclusion: An elevated CVD risk is associated with a lower education status and lack of awareness of CKD diagnosis in people with CKD 3.

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More information

Published date: 2012
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 352916
URI: http://eprints.soton.ac.uk/id/eprint/352916
ISSN: 1660-8151
PURE UUID: 46caea8d-964e-44bd-a321-4d51206cf6f9
ORCID for Simon D.S. Fraser: ORCID iD orcid.org/0000-0002-4172-4406
ORCID for Paul J. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 22 May 2013 10:34
Last modified: 09 Nov 2021 03:18

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Contributors

Author: Natasha J. McIntyre
Author: Scott Harris
Author: Christopher W. McIntyre
Author: Richard J. Fluck
Author: Maarten W. Taal

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