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Socioeconomic disparities in chronic kidney disease
Susanne B Nicholas1, Kamyar Kalantar-Zadeh1, Keith C Norris1
1Division of Nephrology and Division of Endocrinology, Diabetes and Hypertension, David Geffen School of Medicine at University of California, Los Angeles, CA; Division of Nephrology and Hypertension, University of California Irvine, Orange, CA; and Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at University of California, Los Angeles, CA.
Abstract:
CKD is a national public health problem that afflicts persons of all segments of society. Although racial/ethnic disparities in advanced CKD including dialysis-dependent populations have been well established, the finding of differences in CKD incidence, prevalence, and progression across different socioeconomic groups and racial and ethnic strata has only recently started to receive significant attention. Socioeconomics may exert both interdependent and independent effects on CKD and its complications and may confound racial and ethnic disparities. Socioeconomic constellations influence not only access to quality care for CKD risk factors and CKD treatment but may mediate many of the cultural and environmental determinants of health that are becoming more widely recognized as affecting complex medical disorders. In this article, we have reviewed the available literature pertaining to the role of socioeconomic status and economic factors in both non-dialysis-dependent CKD and ESRD. Advancing our understanding of the role of socioeconomic factors in patients with or at risk for CKD can lead to improved strategies for disease prevention and management.
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