Background: Socioeconomic status (SES) is independently associated with chronic kidney disease (CKD)\nprogression; however, its association with other CKD outcomes is unclear. In particular, the potential differential\neffect of SES on mortality among blacks and whites is understudied in CKD. We aimed to examine survival among\nindividuals with prevalent CKD by income and race in the Reasons for Geographic and Racial Differences in Stroke\n(REGARDS) study.\nMethods: We examined 2,761 participants with prevalent CKD stage 3 or 4 between 2003 and 2007 in the\nREGARDS cohort. Participants were followed through March 2013. Mortality from any cause was assessed by\nincome and race (black or white). Low income was defined as an annual household income < $20,000, and was\ncompared to higher incomes (?$20,000). Cox proportional hazards models adjusted for age, gender, education,\ninsurance, CKD stage, comorbidity and county-level poverty were used to estimate hazard ratios (HR) and 95%\nconfidence intervals (CI).\nResults: A total of 750 deaths (27.5%) occurred during the follow-up period. Average follow-up time was 6.6 years\namong those alive and 3.7 years among those who died. Low income participants had an elevated adjusted hazard\nof mortality (HR = 1.58, 95% CI 1.24-2.00) compared to higher income participants. Low income was associated with\nall-cause mortality regardless of race (HR 1.53; 95% CI 1.18-1.99 among blacks and HR 1.38; 95% CI 1.10-1.74 among\nwhites), with no significant statistical interaction between household income and race (p-value = 0.634). However,\nblack participants had a higher adjusted hazard of mortality (HR = 1.30, 95% CI 1.02-1.65) compared to whites, which\nwas independent of income.\nConclusion: Income was associated with increased mortality for both blacks and whites with CKD. Blacks with CKD\nhad higher mortality than whites even after adjusting for important socio-demographic and clinical factors
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