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Published on: June 16, 2014
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Life Course Socioeconomic Status, Allostatic Load, and Kidney Health in Black Americans
Joseph Lunyera1, John W Stanifer2, Clemontina A Davenport3
1Division of General Internal Medicine, Department of Medicine.
Clinical Journal of the American Society of Nephrology : CJASN
|February 21, 2020
Summary
Low socioeconomic status is linked to higher chronic kidney disease (CKD) prevalence, with allostatic load as a key mediator. This association was more pronounced for CKD prevalence than incidence or eGFR decline.
Area of Science:
- Public Health
- Nephrology
- Socioeconomic Determinants of Health
Background:
- Low socioeconomic status (SES) is associated with adverse health outcomes.
- The impact of life course SES on kidney health and the underlying mechanisms remain unclear.
Purpose of the Study:
- To investigate the association between cumulative lifetime SES and chronic kidney disease (CKD) in Black Americans.
- To evaluate allostatic load as a mediator in the relationship between SES and CKD.
Main Methods:
- The Jackson Heart Study cohort (3421 participants) was analyzed.
- Cumulative lifetime SES was derived from childhood SES, education, and income.
- Allostatic load was measured using 11 biomarkers; CKD outcomes included prevalence, eGFR decline, and incidence.
Main Results:
- Lower cumulative lifetime SES was significantly associated with higher CKD prevalence, both directly and via increased allostatic load.
- Lower cumulative lifetime SES was indirectly associated with CKD incidence and modestly faster eGFR decline, mediated by higher allostatic load.
- The association between lower SES and CKD prevalence was substantial, while associations with incidence and eGFR decline were more modest.
Conclusions:
- Cumulative lifetime SES significantly impacts kidney health in Black Americans.
- Allostatic load partially mediates the relationship between lower SES and CKD.
- Findings highlight the importance of addressing socioeconomic factors in kidney disease prevention and management.
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