OBJECTIVE To examine the association between income level and incident chronic kidney disease (CKD) in adults with normal baseline kidney function. PATIENT AND METHODS We studied the association between income level categorized into deciles and incident CKD in a national cohort comprised of 7,405,715 adults who underwent National Health Insurance Service health examinations during January 1, 2009, to December 31, 2015, with baseline estimated glomerular filtration rates (eGFRs) ≥60 mL/min/1.73 m2. Incident CKD was defined as de novo development of eGFR <60 mL/min/1.73 m2 (model 1) or ≥25% decline in eGFR from baseline values accompanied by eGFR <60 mL/min/1.73 m2 (model 2). RESULTS During a median follow-up of 4.8 years, there were 122,032 of 7,405,715 (1.65%) and 55,779 of 7,405,715 (0.75%) incident CKD events based on model 1 and 2 definitions, respectively. Compared with income levels in the sixth decile, there was an inverse association between lower income level and higher risk for CKD up to the fourth decile, above which no additional reduction (model 1) or slightly higher risk for CKD (model 2) was observed at higher income levels. The multivariable-adjusted hazard ratios from the lowest to fourth deciles were 1.30 (95% CI, 1.26-1.33), 1.16 (95% CI, 1.13-1.19), 1.07 (95% CI, 1.05-1.10), and 1.06 (95% CI, 1.03-1.09) in model 1 and 1.32 (95% CI, 1.27-1.37), 1.18 (95% CI, 1.14-1.22), 1.08 (95% CI, 1.04-1.13), and 1.05 (95% CI, 1.01-1.09) in model 2, respectively. These associations persisted across various subgroups of age, sex, and comorbidity status. CONCLUSION In this large nationwide cohort, lower income levels were associated with higher risk for incident CKD.

中文翻译：

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收入差距与慢性肾脏病风险之间的关联：韩国700万成年人的全国队列研究。

目的探讨收入水平与基线肾功能正常的成年人的慢性肾脏病（CKD）之间的关系。患者和方法我们研究了一个全国队列中，按收入水平分类的十亿分之几与CKD事件之间的关联，该队列由7,405,715名成年人组成，他们于2009年1月1日至2015年12月31日接受了美国国家健康保险服务的健康检查，其基线估计肾小球滤过率（eGFR）≥60mL / min / 1.73平方米 CKD事件定义为eGFR从头开始发展<60 mL / min / 1.73 m2（模型1）或eGFR从基线值下降≥25％，并伴有eGFR <60 mL / min / 1.73 m2（模型2）。结果在4.8年的中位随访期中，有122,032例7,405,715（1.65％）和55,779例7,405,715（0。根据模型1和2的定义分别有75％的事件发生了CKD事件。与第六个十分位数的收入水平相比，较低的收入水平和较高的CKD风险直至第四个十分位数之间呈反比关系，在此之上，未观察到其他降低（模型1）或CKD风险略高（模型2）在较高的收入水平。从最低到第四位的多变量调整后的危险比为1.30（95％CI，1.26-1.33），1.16（95％CI，1.13-1.19），1.07（95％CI，1.05-1.10）和1.06（95模型1和1.32（95％CI，1.27-1.37），1.18（95％CI，1.14-1.22），1.08（95％CI，1.04-1.13）和1.05（95％CI）％CI，1.03-1.09） ，1.01-1.09）。这些关联在年龄，性别和合并症状态的各个亚组中均存在。结论在这个庞大的全国性人群中，