Optimism is associated with chronic kidney disease and rapid kidney function decline among African Americans in the Jackson Heart Study

Objective: Investigate the association of dispositional optimism with chronic kidney disease (CKD) and rapid kidney function decline (RKFD) and determine if there is modification by age, sex, and educational attainment among African Americans. Methods: Optimism was measured using the 6-item Life Orientation Test-Revised scale (categorized into tertiles and log transformed) among participants from the Jackson Heart Study (n = 1960). CKD was defined as the presence of albuminuria or reduced glomerular filtration rate of <60 mL/min/1.73m², or report of dialysis at baseline examination (2000–2004). RKFD was defined as a decline >3 mL/min/1.73m²/year between baseline and exam 3 (2009–2013). The cross-sectional and prospective associations between optimism and kidney outcomes were tested using multivariable logistic regression to obtain odds ratios (OR) and 95% confidence intervals (CI), adjusting for demographics, education, risk factors, behaviors, and depressive symptoms. We tested effect modification by age, sex, and education. Results: 569 participants had CKD and 326 were classified as having RKFD by exam 3. After full adjustment, the OR for CKD was 0.73 for those who reported high (vs. low) optimism (95% CI 0.55–0.99) and 0.56 (95% CI 0.27–1.15) for the optimism score. After 7.21 median years of follow up, the OR for RKFD was 0.51 for those who reported high (vs. low) optimism (95% CI 0.34–0.76), and 0.26 (95% CI 0.10–0.56) for the optimism score, after full adjustment. There was no evidence of effect modification by demographics or educational attainment. Conclusions: Higher optimism was associated with a lower odds of CKD and a lower odds of RKFD.