TY - JOUR
T1 - Nondepressive psychosocial factors and CKD outcomes in Black Americans
AU - Lunyera, Joseph
AU - Davenport, Clemontina A.
AU - Bhavsar, Nrupen A.
AU - Sims, Mario
AU - Scialla, Julia
AU - Pendergast, Jane
AU - Hall, Rasheeda
AU - Tyson, Crystal C.
AU - St. Clair Russell, Jennifer
AU - Wang, Wei
AU - Correa, Adolfo
AU - Boulware, L. Ebony
AU - Diamantidis, Clarissa J.
N1 - Funding Information:
The JHS is supported and conducted in collaboration with Jackson State UniversitycontractsHHSN268201300049CandHHSN268201300050C, Tougaloo College contract HHSN268201300048C, and University of Mississippi Medical Center contracts HHSN268201300046C and HHSN268201300047C from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities.
Funding Information:
The authors thank the staffs and participants of the Jackson Heart Study (JHS). The JHS is supported and conducted in collaboration with Jackson State University contracts HHSN268201300049C and HHSN268201300050C, Tougaloo College contract HHSN268201300048C, and University of Mississippi Medical Center contracts HHSN268201300046C and HHSN268201300047C from the National Heart, Lung, and Blood Institute (NHLBI) and the National Institute for Minority Health and Health Disparities. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the NHLBI, the National Institutes of Health, or the US Department of Health and Human Services.
Publisher Copyright:
© 2018 by the American Society of Nephrology.
PY - 2018/2/7
Y1 - 2018/2/7
N2 - Background and objectives Established risk factors for CKD do not fully account for risk of CKD in black Americans. We studied the association of nondepressive psychosocial factors with risk of CKD inthe Jackson Heart Study. Design, setting, participants, & measurements We used principal component analysis to identify underlying constructs from 12 psychosocial baseline variables (perceived daily, lifetime, and burden of lifetime discrimination; stress; anger in; anger out; hostility; pessimism; John Henryism; spirituality; perceived social status; and social support). Using multivariable models adjusted for demographics and comorbidity, we examined the association of psychosocial variables with baseline CKD prevalence, eGFR decline, and incident CKD during follow-up. Results Of 3390 (64%) Jackson Heart Study participants with the required data, 656 (19%) had prevalent CKD. Those with CKD (versus no CKD) had lower perceived daily (mean [SD] score =7.6 [8.5] versus 9.7 [9.0]) and lifetime discrimination (2.5 [2.0] versus 3.1 [2.2]), lower perceived stress (4.2 [4.0] versus 5.2 [4.4]), higher hostility (12.1 [5.2] versus 11.5 [4.8]), higher John Henryism (30.0 [4.8] versus 29.7 [4.4]), and higher pessimism (2.3 [2.2] versus 2.0 [2.1]; all P<0.05). Principal component analysis identified three factors from the 12 psychosocial variables: factor 1, life stressors (perceived discrimination, stress); factor 2, moods (anger, hostility); and, factor 3, coping strategies (John Henryism, spirituality, social status, social support). After adjustments, factor 1 (life stressors) was negatively associated with prevalent CKD at baseline among women only: odds ratio, 0.76 (95% confidence interval, 0.65 to 0.89). After a median follow-up of 8 years, identified psychosocial factors were not significantly associated with eGFR decline (life stressors: β=0.08; 95% confidence interval, 20.02 to 0.17; moods: β=0.03; 95% confidenceinterval, 20.06 to 0.13; coping: β=20.02; 95% confidence interval, 20.12 to 0.08) or incident CKD (life stressors: odds ratio, 1.07; 95% confidence interval, 0.88 to 1.29; moods: odds ratio, 1.02; 95% confidence interval, 0.84 to 1.24; coping: odds ratio, 0.91; 95% confidence interval, 0.75 to 1.11). Conclusions Greater life stressors were associated with lower prevalence of CKD at baseline in the Jackson Heart Study. However, psychosocial factors were not associated with risk of CKD over a median follow-up of 8 years.
AB - Background and objectives Established risk factors for CKD do not fully account for risk of CKD in black Americans. We studied the association of nondepressive psychosocial factors with risk of CKD inthe Jackson Heart Study. Design, setting, participants, & measurements We used principal component analysis to identify underlying constructs from 12 psychosocial baseline variables (perceived daily, lifetime, and burden of lifetime discrimination; stress; anger in; anger out; hostility; pessimism; John Henryism; spirituality; perceived social status; and social support). Using multivariable models adjusted for demographics and comorbidity, we examined the association of psychosocial variables with baseline CKD prevalence, eGFR decline, and incident CKD during follow-up. Results Of 3390 (64%) Jackson Heart Study participants with the required data, 656 (19%) had prevalent CKD. Those with CKD (versus no CKD) had lower perceived daily (mean [SD] score =7.6 [8.5] versus 9.7 [9.0]) and lifetime discrimination (2.5 [2.0] versus 3.1 [2.2]), lower perceived stress (4.2 [4.0] versus 5.2 [4.4]), higher hostility (12.1 [5.2] versus 11.5 [4.8]), higher John Henryism (30.0 [4.8] versus 29.7 [4.4]), and higher pessimism (2.3 [2.2] versus 2.0 [2.1]; all P<0.05). Principal component analysis identified three factors from the 12 psychosocial variables: factor 1, life stressors (perceived discrimination, stress); factor 2, moods (anger, hostility); and, factor 3, coping strategies (John Henryism, spirituality, social status, social support). After adjustments, factor 1 (life stressors) was negatively associated with prevalent CKD at baseline among women only: odds ratio, 0.76 (95% confidence interval, 0.65 to 0.89). After a median follow-up of 8 years, identified psychosocial factors were not significantly associated with eGFR decline (life stressors: β=0.08; 95% confidence interval, 20.02 to 0.17; moods: β=0.03; 95% confidenceinterval, 20.06 to 0.13; coping: β=20.02; 95% confidence interval, 20.12 to 0.08) or incident CKD (life stressors: odds ratio, 1.07; 95% confidence interval, 0.88 to 1.29; moods: odds ratio, 1.02; 95% confidence interval, 0.84 to 1.24; coping: odds ratio, 0.91; 95% confidence interval, 0.75 to 1.11). Conclusions Greater life stressors were associated with lower prevalence of CKD at baseline in the Jackson Heart Study. However, psychosocial factors were not associated with risk of CKD over a median follow-up of 8 years.
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U2 - 10.2215/CJN.06430617
DO - 10.2215/CJN.06430617
M3 - Article
C2 - 29298761
AN - SCOPUS:85041706595
SN - 1555-9041
VL - 13
SP - 213
EP - 222
JO - Clinical Journal of the American Society of Nephrology
JF - Clinical Journal of the American Society of Nephrology
IS - 2
ER -