Impact of Social Determinants of Health on the Prevalence of CKD in Jalisco, Mexico

Le résumé fourni par la source

Background: Social determinants of health have been linked with disparities on the incidence and prevalence of CKD. In Mexico, CKD has become an important public health problem; current guidelines recommend routine CKD testing in patients at increased risk. We report the impact of social determinants of health on the prevalence of chronic kidney disease in Jalisco. Methods: Between 2006-2019 we screened people at risk for the presence of CKD using mobile units that traveled to rural and urban communities of Jalisco. Trained personnel collected demographic and clinical data and obtained blood and urine for serum chemistry and dipstick urinalysis. Individuals who were aware they had kidney disease were not assessed; all others were eligible to participate. GFR was estimated with the EPI-CKD formula. CKD was defined as an eGFR < 60 ml/min/1.73 m2. Results: Between 2016-2019, 63,918 individuals were evaluated. Findings in individuals with CKD and without it were compared. CKD was more prevalent among individuals without schooling (p=< 0.001), homelessness (p=0.003), unemployed (p< 0.001) and lacking health care insurance (p<0.001) (Table 1). By multivariate analysis, illiteracy (OR 1.10, 95% CI 1.01-1.21, p=0.04) and lack of health care insurance (OR 1.12, 95% CI 1.04-1.19, p 0.001) independently increased the risk of CKD. Table 1.- - Demographics characteristics of the participants. CKD n = 5,868 n (%) no-CKD n = 58,050 n (%) p Age (years) 65.9 ±13.4 48.6 ±14.4 <0.001 Female gender 4,340 (74.0%) 36,914 (63.6%) <0.001 DM 1,868 (31.8%) 10,232 (17.6%) <0.001 HTA 3,146 (53.6%) 14,645 (25.2%) <0.001 eGFR (ml/min/1.73m2) 48.9 (11.2) 88.0 (16.0) <0.001 Illiterate 792 (13.5%) 2,689(4.6%) <0.001 Homeless 105 (1.8%) 763 (1.3%) 0.003 Unemployed 3,075 (52.4%) 19,695 (33.9%) <0.001 Uninsured 1,684 (28.7%) 13,663 (23.5%) <0.001 Conclusions: Social determinants of health were associated with a greater prevalence of CKD in our population. Our findings suggest that interventions addressing the social determinant factors are needed in individuals with CKD.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.