BACKGROUND: The relation of food insecurity (inability to acquire nutritionally adequate and safe foods) and chronic kidney disease (CKD) is unknown. We examined whether food insecurity is associated with prevalent CKD among lower-income individuals in both the general US adult population and an urban population. METHODS: We conducted cross-sectional analyses of lower-income participants of the National Health and Nutrition Examination Survey (NHANES) 2003-2008 (n = 9,126) and the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 1,239). Food insecurity was defined based on questionnaires and CKD was defined by reduced estimated glomerular filtration rate or albuminuria; adjustment was performed with multivariable logistic regression. RESULTS: In NHANES, the age-adjusted prevalence of CKD was 20.3, 17.6, and 15.7% for the high, marginal, and no food insecurity groups, respectively. Analyses adjusting for sociodemographics and smoking status revealed high food insecurity to be associated with greater odds of CKD only among participants with either diabetes (OR = 1.67, 95% CI: 1.14-2.45 comparing high to no food insecurity groups) or hypertension (OR = 1.37, 95% CI: 1.03-1.82). In HANDLS, the age-adjusted CKD prevalence was 5.9 and 4.6% for those with and without food insecurity, respectively (p = 0.33). Food insecurity was associated with a trend towards greater odds of CKD (OR = 1.46, 95% CI: 0.98-2.18) with no evidence of effect modification across diabetes, hypertension, or obesity subgroups. CONCLUSION: Food insecurity may contribute to disparities in kidney disease, especially among persons with diabetes or hypertension, and is worthy of further study.
BACKGROUND: The relation of food insecurity (inability to acquire nutritionally adequate and safe foods) and chronic kidney disease (CKD) is unknown. We examined whether food insecurity is associated with prevalent CKD among lower-income individuals in both the general US adult population and an urban population. METHODS: We conducted cross-sectional analyses of lower-income participants of the National Health and Nutrition Examination Survey (NHANES) 2003-2008 (n = 9,126) and the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (n = 1,239). Food insecurity was defined based on questionnaires and CKD was defined by reduced estimated glomerular filtration rate or albuminuria; adjustment was performed with multivariable logistic regression. RESULTS: In NHANES, the age-adjusted prevalence of CKD was 20.3, 17.6, and 15.7% for the high, marginal, and no food insecurity groups, respectively. Analyses adjusting for sociodemographics and smoking status revealed high food insecurity to be associated with greater odds of CKD only among participants with either diabetes (OR = 1.67, 95% CI: 1.14-2.45 comparing high to no food insecurity groups) or hypertension (OR = 1.37, 95% CI: 1.03-1.82). In HANDLS, the age-adjusted CKD prevalence was 5.9 and 4.6% for those with and without food insecurity, respectively (p = 0.33). Food insecurity was associated with a trend towards greater odds of CKD (OR = 1.46, 95% CI: 0.98-2.18) with no evidence of effect modification across diabetes, hypertension, or obesity subgroups. CONCLUSION: Food insecurity may contribute to disparities in kidney disease, especially among persons with diabetes or hypertension, and is worthy of further study.
Authors: Stein I Hallan; Josef Coresh; Brad C Astor; Arne Asberg; Neil R Powe; Solfrid Romundstad; Hans A Hallan; Stian Lydersen; Jostein Holmen Journal: J Am Soc Nephrol Date: 2006-06-21 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: Hilary K Seligman; Andrew B Bindman; Eric Vittinghoff; Alka M Kanaya; Margot B Kushel Journal: J Gen Intern Med Date: 2007-04-11 Impact factor: 5.128
Authors: Sharon Stein Merkin; Ana V Diez Roux; Josef Coresh; Linda F Fried; Sharon A Jackson; Neil R Powe Journal: Soc Sci Med Date: 2007-05-11 Impact factor: 4.634
Authors: Tanushree Banerjee; Deidra C Crews; Donald E Wesson; Sai Dharmarajan; Rajiv Saran; Nilka Ríos Burrows; Sharon Saydah; Neil R Powe Journal: Am J Kidney Dis Date: 2017-02-16 Impact factor: 8.860
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: Tessa Novick; Yang Liu; Anika Alvanzo; Alan B Zonderman; Michele K Evans; Deidra C Crews Journal: Am J Nephrol Date: 2016-10-28 Impact factor: 3.754
Authors: Augustine M Saiz; Allison M Aul; Kristen M Malecki; Andrew J Bersch; Rachel S Bergmans; Tamara J LeCaire; F Javier Nieto Journal: Prev Med Date: 2016-09-06 Impact factor: 4.018
Authors: Seth A Berkowitz; Hilary K Seligman; Joseph Rigdon; James B Meigs; Sanjay Basu Journal: JAMA Intern Med Date: 2017-11-01 Impact factor: 21.873