Rachael L. Morton|Iryna Schlackow|Natalie Staplin|Alastair Gray|Alan Cass|Richard Haynes|Jonathan Emberson|William G Herrington|Martin J Landray|Colin Baigent|Borislava Mihaylova
Impact of Educational Attainment on Health Outcomes in Moderate to Severe CKD
University of Sydney|National Health and Medical Research Council|University of Oxford|University of Oxford|University of Oxford|University of Oxford|Charles Darwin University|Menzies School of Health Research|University of Oxford|University of Oxford|University of Oxford|University of Oxford|University of Oxford|University of Oxford
inverse association educational attainment mortality well established relevance vascular events renal progression population chronic kidney disease ckd less clear study aims determine association highest educational attainment risk vascular events causespecific mortality ckd progressionprospective epidemiologic analysis among participants study heart renal protection sharp randomized controlled trial9270 adults moderate severe ckd 6245 receiving dialysis baseline history myocardial infarction coronary revascularization recruited europe north america asia australia new zealandhighest educational attainment measured study entry using 6 levels ranged formal education tertiary educationany vascular event fatal nonfatal cardiac cerebrovascular peripheral vascular event causespecific mortality ckd progression 49 years median followupthere significant trend p0001 toward increased vascular risk decreasing levels education participants formal education 46 higher risk vascular events relative risk rr 146 95 ci 114186 compared participants tertiary education trend mortality across education levels also significant p0001 allcause mortality twice high among formal education compared tertiaryeducated individuals rr 205 95 ci 162258 significant increases seen vascular rr 184 95 ci 121281 nonvascular rr 215 95 ci 160289 deaths lifestyle factors prior disease explain excess mortality risk among 6245 participants receiving dialysis baseline education level significantly associated progression endstage renal disease doubling creatinine level p trend 04no data employment health insurance coveragelower educational attainment associated increased risk adverse health outcomes individuals ckd