Chronic kidney disease and life course socioeconomic status: a review

Socioeconomic status (SES) may modify the effect of well-established risk factors on the development of kidney disease. Yet, recently, a paradigm shift has occurred with an emphasis on the direct effect of SES on the development of disease. This article covers the role SES may play in initiating and promoting chronic kidney disease (CKD) in the United States, with an emphasis on life-course SES. The literature on SES and kidney disease is discussed. Life-course and social epidemiology approaches are described. Salient risk factors and markers that are associated with both SES and kidney disease early in life include diet, birth weight, and infant mortality. Risk factors associated with individual SES later in life include diabetes mellitus, hypertension, diet, smoking, alcohol, drug use, occupational and environmental exposures, infection, and access to health care. An argument is made for incorporating area-level SES measures. Future research should incorporate both individual and area-level SES and be placed in the context of the life course.