scholarly journals The Association Between Household Income, Food Security, and Prevalence of Chronic Kidney Disease in Elderly Patients

Author(s):  
Hyuk Huh ◽  
Je Hun Song ◽  
Hong Yeop Kim ◽  
Hoseok Koo ◽  
Kyung Don Yoo

Abstract This study aimed to clarify the association between food security and the prevalence of chronic disease. We analyzed the variables of The Korea National Health and Nutrition Examination Survey V (2010–2012), and VI (2013–2015) while merging data of the food security questionnaire of four years. We included 15,945 participants, performed propensity score matched analysis by quartile of household income (i.e., low, low-mid, high-mid, high) and sex, and presented the results by age group. Systolic blood pressure and proportion of current smokers were significantly higher in the elderly group, compared with the middle-aged group. The prevalence of hypertension, diabetes mellitus (DM), metabolic syndrome, and chronic kidney disease (CKD) did not differ significantly by income level in the elderly group. The food security questionnaire revealed that food security insurance was significantly lower in the low-income level (1st quartile), compared with that in the high-income level (4th quartile). The logistic regression analysis for the association between the prevalence of chronic disease and food insecurity confirmed no significant association with hypertension and DM. Food insecurity might be associated with CKD prevalence, especially in the elderly population.

2021 ◽  
Vol 10 (14) ◽  
pp. 3022
Author(s):  
Ander Vergara ◽  
Mireia Molina-Van den Bosch ◽  
Néstor Toapanta ◽  
Andrés Villegas ◽  
Luis Sánchez-Cámara ◽  
...  

Age and chronic kidney disease have been described as mortality risk factors for coronavirus disease 2019 (COVID-19). Currently, an important percentage of patients in haemodialysis are elderly. Herein, we investigated the impact of age on mortality among haemodialysis patients with COVID-19. Data was obtained from the Spanish COVID-19 chronic kidney disease (CKD) Working Group Registry. From 18 March 2020 to 27 August 2020, 930 patients on haemodialysis affected by COVID-19 were included in the Registry. A total of 254 patients were under 65 years old and 676 were 65 years or older (elderly group). Mortality was 25.1% higher (95% CI: 22.2–28.0%) in the elderly as compared to the non-elderly group. Death from COVID-19 was increased 6.2-fold in haemodialysis patients as compared to the mortality in the general population in a similar time frame. In the multivariate Cox regression analysis, age (hazard ratio (HR) 1.59, 95% CI: 1.31–1.93), dyspnea at presentation (HR 1.51, 95% CI: 1.11–2.04), pneumonia (HR 1.74, 95% CI: 1.10–2.73) and admission to hospital (HR 4.00, 95% CI: 1.83–8.70) were identified as independent mortality risk factors in the elderly haemodialysis population. Treatment with glucocorticoids reduced the risk of death (HR 0.68, 95% CI: 0.48–0.96). In conclusion, mortality is dramatically increased in elderly haemodialysis patients with COVID-19. Our results suggest that this high risk population should be prioritized in terms of protection and vaccination.


2019 ◽  
Vol 25 (4) ◽  
pp. 245-252 ◽  
Author(s):  
Srikanta Banerjee ◽  
Timothy Radak

Background: Food insecurity is known to be a major public health issue. There is limited data on food insecurity and chronic disease in the general population. Aim: We aimed to assess effect of food insecurity on mortality of individuals with chronic disease like cardiorenal syndrome (CRS). Methods: The study was conducted on participants aged 20 years or older in the United States living below the 130% Federal Poverty Level. We assessed food insecurity utilizing the Household Food Security Survey Module in NHANES survey for the years 1999 to 2010 with mortality follow-up. Prospective analysis was performed using complex samples Cox regression with adjustment for known confounders to determine the relationship of food insecurity and CRS. Results: Prevalence of food insecurity among the low-income population was 16.1% among males and 21.7% among females. The mean follow-up was 6.5 years. For all-cause mortality, the overall unadjusted hazard ratio (HR) of food insecurity to no food insecurity was 1.28 (95% confidence interval [CI], 1.18–1.37, p < 0.001). Adjusted HR was elevated, 2.81 (CI 1.57–5.05, p < 0.001), among participants who were CRS-positive and food insecure but closer to 1.0 (2.48 CI 1.73–3.55, p < 0.001) among those who were CRS-positive and food secure, after controlling for medical and demographic risk factors. Conclusions: Food insecurity is associated with higher mortality than food security. Food insecurity also may modify the effect of CRS on all-cause mortality in a representative general population. Social policy, when addressing food insecurity, should be inclusive among those with specific chronic diseases.


2011 ◽  
Vol 15 (2) ◽  
pp. 227-237 ◽  
Author(s):  
Rebecca Ramsey ◽  
Katrina Giskes ◽  
Gavin Turrell ◽  
Danielle Gallegos

AbstractObjectiveFood insecurity is the limited or uncertain availability or access to nutritionally adequate, culturally appropriate and safe foods. Food insecurity may result in inadequate dietary intakes, overweight or obesity and the development of chronic disease. Internationally, few studies have focused on the range of potential health outcomes related to food insecurity among adults residing in disadvantaged locations and no such Australian studies exist. The objective of the present study was to investigate associations between food insecurity, sociodemographic and health factors and dietary intakes among adults residing in disadvantaged urban areas.DesignData were collected by mail survey (n505, 53 % response rate), which ascertained information about food security status, demographic characteristics (such as age, gender, household income, education) fruit and vegetable intakes, takeaway and meat consumption, general health, depression and chronic disease.SettingDisadvantaged suburbs of Brisbane city, Australia, 2009.SubjectsIndividuals aged ≥ 20 years.ResultsApproximately one in four households (25 %) was food insecure. Food insecurity was associated with lower household income, poorer general health, increased health-care utilisation and depression. These associations remained after adjustment for age, gender and household income.ConclusionsFood insecurity is prevalent in urbanised disadvantaged areas in developed countries such as Australia. Low-income households are at high risk of experiencing food insecurity. Food insecurity may result in significant health burdens among the population, and this may be concentrated in socio-economically disadvantaged suburbs.


2014 ◽  
Vol 12 (1) ◽  
pp. 95-104
Author(s):  
MA Quddus ◽  
S Bauer

The study was undertaken to assess the food consumption level, prevalence of food insecurity and health status of elderly in the disadvantaged rural area of Bangladesh. Data were collected from fifteen villages in three vulnerable regions (river-flooded, hilly and coastal) through self-completed questionnaire. Descriptive statistics of sociodemographic characteristics of 282 households, food frequency and overall health status of elderly were measured. Economic, demographic and some other household characteristic factors influencing food insecurity of elderly people was estimated using binary logistic regression model. Socio-demographic factors influencing morbidity of elderly people were estimated using Chi-square statistics. Socioeconomic conditions of the studied areas were poor and they spent above 83% of their income for food. Rice, wheat, pulses and vegetables were the highly consumed and fruits and sweets were the less consumed foods by the elderly people. One-fourth and two-third of the elderly people had eaten fish and meat, respectively less than a week. Food insecurity was inversely associated with household income and level of education of elderly people and positively associated with number of household member. Food security was 3.5 times more likely to the oldest elder (75 years) as compared with older elder (< 75 years). Elderly people of age group 75 years and over were more prevalence of morbidities and 23.8% elders were suffering from severe morbidity. Also they suffered from treatment facilities. Higher age, low income, food insecurity and anxiety were the major causes of their morbidity. No significant morbidity differentials existed among different sexes, farm size and study locations. Proper intervention programs should be designed and implemented to control the prevalence of health and food availability for the elderly. DOI: http://dx.doi.org/10.3329/jbau.v12i1.21254 J. Bangladesh Agril. Univ. 12(1): 95-104, June 2014


BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019457 ◽  
Author(s):  
Shuang Liang ◽  
Wen-Ling Wang ◽  
Fang-Lei Zhu ◽  
Shu-Wei Duan ◽  
Xue-Feng Sun ◽  
...  

IntroductionThe proportion of elderly people is steadily rising worldwide, especially in low-income and middle-income countries, including China. Chronic kidney disease (CKD) is a common disorder in older people. However, little is known about the epidemiology of CKD and its consequences among the elderly. Improvements on clinical guidelines and healthcare policies for this population are required. This study aims to examine the risk factors for progression of CKD among the elderly and develop models to identify subgroups who are at high risk.Methods and analysisThis is a prospective, multicentre, cohort study. The study population comprises ~3000 patients with predialysis CKD, aged ≥65 years, recruited between March 2016 and December 2017. After the baseline assessments, these patients will be followed for 5 years or until the occurrence of primary outcomes. Assessments that include anthropomorphic measures, laboratory tests, questionnaires, and blood and urine specimen collection will be performed at baseline and at follow-ups. Data on demographic information, cognitive function, depression, risk of malnutrition, physical activity and quality of life will be collected. The primary outcomes are incidence of end-stage renal disease, loss of renal function (≥40% decline in glomerular filtration rate from baseline), and death. The secondary outcomes are acute coronary syndrome, hospitalisation for heart failure or unstable angina, cerebrovascular events, and peripheral arterial disease.Ethics and disseminationThis study protocol has been approved by the ethics committees of the Chinese People’s Liberation Army General Hospital and the participating centres. All the participants gave written informed consent before data collection. The findings of the study will be published in peer-reviewed journals and will be presented at national or international conferences.Trial registration numberNCT03246204; Pre-results.


2021 ◽  
Vol 13 (9) ◽  
pp. 5294
Author(s):  
Boglárka Anna Éliás ◽  
Attila Jámbor

For decades, global food security has not been able to address the structural problem of economic access to food, resulting in a recent increase in the number of undernourished people from 2014. In addition, the FAO estimates that the number of undernourished people drastically increased by 82–132 million people in 2020 due to the COVID-19 pandemic. To alleviate this dramatic growth in food insecurity, it is necessary to understand the nature of the increase in the number of malnourished during the pandemic. In order to address this, we gathered and synthesized food-security-related empirical results from the first year of the pandemic in a systematic review. The vast majority (78%) of the 51 included articles reported household food insecurity has increased (access, utilization) and/or disruption to food production (availability) was a result of households having persistently low income and not having an adequate amount of savings. These households could not afford the same quality and/or quantity of food, and a demand shortfall immediately appeared on the producer side. Producers thus had to deal not only with the direct consequences of government measures (disruption in labor flow, lack of demand of the catering sector, etc.) but also with a decline in consumption from low-income households. We conclude that the factor that most negatively affects food security during the COVID-19 pandemic is the same as the deepest structural problem of global food security: low income. Therefore, we argue that there is no need for new global food security objectives, but there is a need for an even stronger emphasis on poverty reduction and raising the wages of low-income households. This structural adjustment is the most fundamental step to recover from the COVID-19 food crises, and to avoid possible future food security crises.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Feyza Bora ◽  
Emine Asar ◽  
Fatih Yılmaz ◽  
Ümit Çakmak ◽  
Fevzi F Ersoy ◽  
...  

Abstract Background and Aims It is evident that Chronic Kidney Disease (CKD) influences the risk of developing AKI (Acute Kidney Injury) and recent studies suggest that CKD patients who experienced an episode of AKI are more likely to progress to end stage renal disease (ESRD) than patients without CKD. AKI-CKD association might originate from common comorbidities associated with both AKI and CKD, such as diabetes and/or hypertension, and concurrent increase in interventions leading to frequent exposure to various nephrotoxins. AKI in the elderly has been shown to increase the risk of progression to CKD to ESRD. AKI is common in critically ill patients, and those patients with the most severe form of AKI, requiring RRT, have a mortality rate of 50–80 %. Patients with an eGFR &lt;45 ml/min per 1.73m2 who experienced an episode of dialysis-requiring AKI were at very high risk for impaired recovery of renal function. Our aim was to determine the reasons that initiate hemodialysis (renal decompensation) in patients with regular follow-up in the low clearance polyclinic without renal replacement treatment (RRT). Method The retrospective study included predialysis CKD patients who had followed up regularly and had undergone RRT in recent 4 years. Data on baseline characteristics and medical history were obtained from patient hospital records. Results Of the 228 patients, 155 (68%) were male and 73 (32%) were female. The mean age was 58 years (45-66). Diabetes Mellitus was the first in the etiology of CKD (26,3 %), the second was unknown (12,7 %), the third was hypertension (11,8 %). 145 patients (63,6%) underwent regular hemodialysis (HD) (62 years, 55-69), 25 patients (11%) began peritoneal dialysis (PD), 58 patients (25%) had renal transplantation. 52 patients underwent HD with renal decompensation, 22 (%42,3) had working arteriovenous fistula (AVF). There was no decompensation in patients with PD or transplantation plan. 34 patients started HD because of infections (65%), 8 patients (15%) after operations (4 was Coronary Artery Bypass Grafting-CABG), 6 patients (%11,5) after coronary angiography, 4 patients (7,5%) with cardiac decompensation. 2 patients died during the hospitalisation for infections. Of 145 HD patients, 89 (%61,4) had AVF. The patients who had renal decompensation were more older 63 (58-70), have lower Hgb 9,7 g/L (9,1-10,7) and albumin 3,5 g/L (3,2-3,9) level (p&lt;0,05). There was no difference in eGFR at the beginning of HD between renal decompensation and other HD patients. 42 patients did not undergo HD at the time we suggested during visits. Of them 9 patients (%21) had renal decompensation (6 infections,3 CABG), 17 patients (%40) had AVF. 3 of them died. The others underwent HD for uremic complications. Conclusion We have shown that infections are as the leading cause of renal decompensation. Most of our patients who started to RRT from our low clearance outpatient clinic have chosen HD for RRT. Prevention of infections via vaccination programs or early diagnosis at regular policlinic or telephone visits, and informing patients adequately about nephrotoxic drugs or the conditions that may cause renal decompensation are among the first tasks of the predialysis outpatient clinic. Transition of CKD patients to RRTs, with proper preparation, neither late nor early- at the most appropriate time- should be among in our goals. This may reduce the cost of ESRD patients.


2017 ◽  
Vol 14 (8) ◽  
pp. 735-740 ◽  
Author(s):  
Kai-Yin Hung ◽  
Terry Ting-Yu Chiou ◽  
Chien-Hsing Wu ◽  
Ying-Chun Liao ◽  
Chian-Ni Chen ◽  
...  

2017 ◽  
Vol 7 (2) ◽  
pp. 132-137
Author(s):  
Abdul Latif ◽  
Muhammad Rafiqul Alam ◽  
Asia Khanam ◽  
Farhana Hoque ◽  
Muhammad Abdur Rahim ◽  
...  

Background: Anemia is common in patients with chronic kidney disease (CKD) and this is generally anemia of chronic disease, but iron deficiency anemia (IDA) is also common. Soluble transferrin receptor (sTfR) is a useful marker for IDA. Present study was undertaken to assess the utility of sTfR as a marker of IDA in selected group of Bangladeshi patients with CKD.Methods: This cross-sectional study was conducted in the Department of Nephrology, BSMMU, Dhaka, Bangladesh from January 2013 to December 2014. Patients with anemia admitted in nephrology department whether on hemodialysis or not and medicine department of BSMMU were taken for study. The study population was further divided into two groups; Group A, patients who are having IDA and Group B, patients with ACD and a control group was also selected. Data were collected by face to face interview and laboratory investigations with a self-administered questionnaire.Results: The mean age of the patients in two study groups were 38.40±13.23 and 34.85±10.52 years respectively and male-female ratio were 0.5:1 and 1:0.5. Mean sTfR level was higher (4.81± 1.64 ?g/ml) in patients with IDA than (2.89±1.40 ?g/ml) in patients with ACD (p <0.0001). In our study mean ferritin level was 599.59± 449.15?g/L in ACD patients whereas 101.23±119.42 in IDA patients (p<0.0001). Total iron binding capacity (TIBC) was more in ACD patients with sTfRe”3?g/ml as compared to ACD patients with sTfR<3?g/ml. Transferrin saturation (TSAT) level was significantly decreased in ACD patients with sTfR ?3?g/ml as compared to ACD patients with sTfR<3?g/ml.Conclusion: sTfR has a comparable ability to S. ferritin in diagnosing IDA and ACD. However, sTfR and serum ferritin alone cannot definitely exclude co-existing iron deficiency in ACD. As sTfR is not affected by infection and/or inflammation, thus providing a non-invasive alternative to bone marrow study.Birdem Med J 2017; 7(2): 132-137


Sign in / Sign up

Export Citation Format

Share Document