Kidney Disease in Life-Course Socioeconomic Context: The Atherosclerosis Risk in Communities (ARIC) Study

David A. Shoham, Suma Vupputuri, Ana V. Diez Roux, Jay S. Kaufman, Josef Coresh, Abhijit V. Kshirsagar, Donglin Zeng, Gerardo Heiss

Research output: Contribution to journalArticlepeer-review

62 Scopus citations


Background: Persons belonging to the working class or living in an adverse social environment at particular periods of their life course may have an increased risk of chronic kidney disease (CKD). Methods: This hypothesis was examined among participants of the Life Course Socioeconomic Status Study, an ancillary study of the Atherosclerosis Risk in Communities Study, conducted in 2001 (mean age, 67.4 years; N = 12,631). CKD was defined by hospital discharge diagnosis and/or estimated glomerular filtration rate less than 45 mL/min/1.73 m2 (<0.75 mL/s/1.73 m2). Social class was categorized as working class or non-working class at ages 30, 40, or 50 years. Area-level socioeconomic status was based on a composite of census scores during the same period. Adjusted odds ratios were obtained within strata of white and African-American race. Results: The adjusted odds ratio of CKD for persons belonging to the working class versus non-working class at age 30 was 1.4 (95% confidence interval, 1.0 to 2.0) in whites and 1.9 (95% confidence interval, 1.1 to 3.0) in African Americans. Working class membership was associated with CKD, even at earlier stages of adult life, and class was associated more strongly with CKD than was education. Working class membership also suggested a stronger association with CKD among African Americans than whites, independent of diabetes and hypertension status. At later periods in the life course, area socioeconomic status was associated with CKD. Conclusion: Socioeconomic factors, including area socioeconomic status and social class, are associated with CKD and may account for some of the racial disparity in kidney disease.

Original languageEnglish (US)
Pages (from-to)217-226
Number of pages10
JournalAmerican Journal of Kidney Diseases
Issue number2
StatePublished - Feb 2007
Externally publishedYes


  • Kidney diseases
  • continental population groups
  • residence characteristics
  • social class

ASJC Scopus subject areas

  • Nephrology


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