BACKGROUND: Albuminuria is an important risk factor for progressive chronic kidney disease (CKD) and is more prevalent in black than white adults. We sought to determine the association between low income and albuminuria and whether this association differs for blacks and whites. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: 9,144 black and 13,684 white US adults 45 years and older in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. PREDICTORS: Self-reported annual household income category (≥$75,000, $35,000-$74,999, $20,000-$34,999, and <$20,000); black and white race. OUTCOMES & MEASUREMENTS: Albuminuria defined as high (30-300 mg/g) or very high (>300 mg/g) urinary albumin-creatinine ratio (ACR). Multinomial logistic regression used to examine the race-stratified association between categories of income and albuminuria (normal, high, or very high ACR). RESULTS: Overall, geometric mean ACR was 10.2 mg/g and was higher for blacks (11.8 mg/g) than whites (9.3 mg/g), P<0.001. Lower income was associated with a higher prevalence of albuminuria for both whites and blacks in unadjusted analyses. After adjustment for demographics, lifestyle factors, comorbid illnesses, and estimated glomerular filtration rate, there was a trend toward a stronger association between lower income levels and high ACR in blacks (ORs of 1.38 [95% CI, 1.07-1.77], 1.36 [95% CI, 1.05-1.75], and 1.58 [95% CI, 1.21-2.05] for income levels of $35,000-$74,999, $20,000-$34,999, and <$20,000, respectively; reference group is those with income≥$75,000) compared with whites (ORs of 0.95 [95% CI, 0.81-1.12], 0.95 [95% CI, 0.79-1.14], and 1.26 [95% CI, 1.02-1.55], respectively); P interaction=0.08 between race and income. Results were similar for very high ACR and subgroups of participants with diabetes or hypertension. LIMITATIONS: Cross-sectional design; not all REGARDS participants provided their annual income. CONCLUSIONS: Lower income may be associated more strongly with albuminuria in blacks than whites and may be a determinant of racial disparities in albuminuria.
BACKGROUND:Albuminuria is an important risk factor for progressive chronic kidney disease (CKD) and is more prevalent in black than white adults. We sought to determine the association between low income and albuminuria and whether this association differs for blacks and whites. STUDY DESIGN: Cross-sectional study. SETTING & PARTICIPANTS: 9,144 black and 13,684 white US adults 45 years and older in the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. PREDICTORS: Self-reported annual household income category (≥$75,000, $35,000-$74,999, $20,000-$34,999, and <$20,000); black and white race. OUTCOMES & MEASUREMENTS: Albuminuria defined as high (30-300 mg/g) or very high (>300 mg/g) urinary albumin-creatinine ratio (ACR). Multinomial logistic regression used to examine the race-stratified association between categories of income and albuminuria (normal, high, or very high ACR). RESULTS: Overall, geometric mean ACR was 10.2 mg/g and was higher for blacks (11.8 mg/g) than whites (9.3 mg/g), P<0.001. Lower income was associated with a higher prevalence of albuminuria for both whites and blacks in unadjusted analyses. After adjustment for demographics, lifestyle factors, comorbid illnesses, and estimated glomerular filtration rate, there was a trend toward a stronger association between lower income levels and high ACR in blacks (ORs of 1.38 [95% CI, 1.07-1.77], 1.36 [95% CI, 1.05-1.75], and 1.58 [95% CI, 1.21-2.05] for income levels of $35,000-$74,999, $20,000-$34,999, and <$20,000, respectively; reference group is those with income≥$75,000) compared with whites (ORs of 0.95 [95% CI, 0.81-1.12], 0.95 [95% CI, 0.79-1.14], and 1.26 [95% CI, 1.02-1.55], respectively); P interaction=0.08 between race and income. Results were similar for very high ACR and subgroups of participants with diabetes or hypertension. LIMITATIONS: Cross-sectional design; not all REGARDS participants provided their annual income. CONCLUSIONS: Lower income may be associated more strongly with albuminuria in blacks than whites and may be a determinant of racial disparities in albuminuria.
Authors: Allan J Collins; Robert N Foley; Blanche Chavers; David Gilbertson; Charles Herzog; Kirsten Johansen; Bertram Kasiske; Nancy Kutner; Jiannong Liu; Wendy St Peter; Haifeng Guo; Sally Gustafson; Brooke Heubner; Kenneth Lamb; Shuling Li; Suying Li; Yi Peng; Yang Qiu; Tricia Roberts; Melissa Skeans; Jon Snyder; Craig Solid; Bryn Thompson; Changchun Wang; Eric Weinhandl; David Zaun; Cheryl Arko; Shu-Cheng Chen; Frank Daniels; James Ebben; Eric Frazier; Christopher Hanzlik; Roger Johnson; Daniel Sheets; Xinyue Wang; Beth Forrest; Edward Constantini; Susan Everson; Paul Eggers; Lawrence Agodoa Journal: Am J Kidney Dis Date: 2012-01 Impact factor: 8.860
Authors: William M McClellan; Britt B Newsome; Leslie A McClure; George Howard; Nataliya Volkova; Paul Audhya; David G Warnock Journal: Am J Nephrol Date: 2010-05-31 Impact factor: 3.754
Authors: Giulio Genovese; David J Friedman; Michael D Ross; Laurence Lecordier; Pierrick Uzureau; Barry I Freedman; Donald W Bowden; Carl D Langefeld; Taras K Oleksyk; Andrea L Uscinski Knob; Andrea J Bernhardy; Pamela J Hicks; George W Nelson; Benoit Vanhollebeke; Cheryl A Winkler; Jeffrey B Kopp; Etienne Pays; Martin R Pollak Journal: Science Date: 2010-07-15 Impact factor: 47.728
Authors: Ron T Gansevoort; Kunihiro Matsushita; Marije van der Velde; Brad C Astor; Mark Woodward; Andrew S Levey; Paul E de Jong; Josef Coresh Journal: Kidney Int Date: 2011-02-02 Impact factor: 10.612
Authors: Marino A Bruce; Bettina M Beech; Errol D Crook; Mario Sims; Sharon B Wyatt; Michael F Flessner; Herman A Taylor; David R Williams; Ermeg L Akylbekova; T Alp Ikizler Journal: Am J Kidney Dis Date: 2010-04-08 Impact factor: 8.860
Authors: William M McClellan; David G Warnock; Suzanne Judd; Paul Muntner; Reshma Kewalramani; Mary Cushman; Leslie A McClure; Britt B Newsome; George Howard Journal: J Am Soc Nephrol Date: 2011-08-25 Impact factor: 10.121
Authors: Daniel J Brotman; Lori D Bash; Rehan Qayyum; Deidra Crews; Eric A Whitsel; Brad C Astor; Josef Coresh Journal: J Am Soc Nephrol Date: 2010-07-08 Impact factor: 10.121
Authors: Deidra C Crews; Raquel F Charles; Michele K Evans; Alan B Zonderman; Neil R Powe Journal: Am J Kidney Dis Date: 2010-03-06 Impact factor: 8.860
Authors: Barry I Freedman; Carl D Langefeld; Lingyi Lu; Jasmin Divers; Mary E Comeau; Jeffrey B Kopp; Cheryl A Winkler; George W Nelson; Randall C Johnson; Nicholette D Palmer; Pamela J Hicks; Meredith A Bostrom; Jessica N Cooke; Caitrin W McDonough; Donald W Bowden Journal: PLoS Genet Date: 2011-06-16 Impact factor: 5.917
Authors: Jenna M Norton; Marva M Moxey-Mims; Paul W Eggers; Andrew S Narva; Robert A Star; Paul L Kimmel; Griffin P Rodgers Journal: J Am Soc Nephrol Date: 2016-05-13 Impact factor: 10.121
Authors: Deidra C Crews; Marie Fanelli Kuczmarski; Edgar R Miller; Alan B Zonderman; Michele K Evans; Neil R Powe Journal: J Ren Nutr Date: 2014-09-17 Impact factor: 3.655
Authors: Deidra C Crews; Marie Fanelli Kuczmarski; Vanessa Grubbs; Elizabeth Hedgeman; Vahakn B Shahinian; Michele K Evans; Alan B Zonderman; Nilka Rios Burrows; Desmond E Williams; Rajiv Saran; Neil R Powe Journal: Am J Nephrol Date: 2014-01-08 Impact factor: 3.754
Authors: Bessie A Young; Ronit Katz; L Ebony Boulware; Bryan Kestenbaum; Ian H de Boer; Wei Wang; Tibor Fülöp; Nisha Bansal; Cassianne Robinson-Cohen; Michael Griswold; Neil R Powe; Jonathan Himmelfarb; Adolfo Correa Journal: Am J Kidney Dis Date: 2016-04-09 Impact factor: 8.860
Authors: Priya Vart; Ron T Gansevoort; Josef Coresh; Sijmen A Reijneveld; Ute Bültmann Journal: Clin J Am Soc Nephrol Date: 2013-06-27 Impact factor: 8.237