Does wealth make health? Cherchez la renal replacement therapy
Journal Title: Clinical Kidney Journal - Year 2017, Vol 10, Issue 1
Abstract
In this issue of CKJ, McQuarrie et al. have explored the relationship between socioeconomic status and outcomes among Scottish patients with a renal biopsy diagnosis of primary glomerulonephritis. Patients in the lower socioeconomic category had a twofold higher risk of death. No significant differences were observed on progression to end-stage renal disease (ESRD) requiring renal replacement therapy (RRT), suggesting that overall medical management was appropriate for all socioeconomic categories. The findings are significant since they come from an ethnically homogeneous population with free access to healthcare; they also relate to a specific aetiology of chronic kidney disease (CKD) expected to be less dependent on unhealthy lifestyles than other more frequent aetiologies that dominate studies of CKD in general, such as diabetic or hypertensive nephropathy. A closer look at the data suggests that living in a high socioeconomic area is associated with lower mortality, rather than the other way round. Furthermore, the differences in mortality were most pronounced during the RRT stage of CKD, providing clues for further research. In this regard, Wilmink et al. and Nee et al. point to access to pre-ESRD nephrology care and to the best kidney transplantation options as modifiable factors to be studied in the realm of T3 translational research to improve CKD patient outcomes.
Authors and Affiliations
Maria D. Sanchez-Niño, Alberto Ortiz
Circulating miRNAs as biomarkers of kidney disease
Interest in microRNAs (miRNAs) has dramatically increased in recent years not only because they regulate mRNA expression, and thus many physiological or pathophysiological processes, but also because they could serve as...
Looking for the needle in the kidney transplantation haystack
The diagnosis of acute rejection still relies on renal allograft biopsy. In fact, histological features including C4d staining can be useful to differentiate cellular and antibody-mediated acute rejection. However, the p...
Impact of poverty and race on pre-end-stage renal disease care among dialysis patients in the United States
Access to nephrology care prior to end-stage renal disease (ESRD) is significantly associated with lower rates of morbidity and mortality. We assessed the association of area-level and individual-level indicators of pove...
Effect of ethnicity and socioeconomic status on vascular access provision and performance in an urban NHS hospital
The aim of this study was to examine the effect of ethnicity, socioeconomic group (SEG) and comorbidities on provision of vascular access for haemodialysis (HD).
Multiple socioeconomic deprivation and impact on survival in patients with primary glomerulonephritis
The Glasgow Renal and Transplant Unit provides renal services to the West of Scotland, population 1.6 million. Ninewells Hospital Dundee (NWD) is located in the East of Scotland and covers a population of 400 000...