Socioeconomic Disparities in Chronic Kidney Disease

Chronic kidney disease (CKD) affects populations across all income strata, yet its incidence, progression and outcomes are profoundly influenced by socioeconomic factors. Individuals with lower incomes, limited education or marginalised ethnic status experience higher rates of CKD onset, more rapid progression to advanced stages and greater likelihood of premature mortality. These disparities arise from interwoven determinants such as unequal access to preventive care, variations in health literacy, differences in comorbidity burdens (notably diabetes and hypertension) and uneven exposure to environmental risks. Moreover, systemic barriers—ranging from gaps in health insurance to neighbourhood deprivation—exacerbate disease trajectories. Even in settings with universal health coverage, income gradients persist in influencing loss of renal function and initiation of kidney replacement therapy. Recognising and addressing these inequities is vital to reduce the global CKD burden, inform equitable screening strategies and optimise resource allocation. Multilevel interventions targeting both individual behaviours and broader social determinants are gaining prominence as pathways to mitigate the disproportionate impact of CKD on disadvantaged groups.

Research from Nature Portfolio

No recent Nature Portfolio content available.

Socioeconomic Disparities in Chronic Kidney Disease publication trend

The graph below shows the total number of articles in socioeconomic disparities in chronic kidney disease across all publications each year (not limited to Nature Index journals).

Technical terms

Chronic Kidney Disease (CKD): A prolonged, often progressive decline in kidney function, classified into stages 1–5 based on eGFR and evidence of kidney damage.

End-Stage Renal Disease (ESRD): The most severe stage of CKD (stage 5) in which renal replacement therapy—dialysis or transplantation—is required for survival.

Estimated Glomerular Filtration Rate (eGFR): A calculated measure of kidney filtration capacity, expressed in mL/min/1.73 m², used to stage CKD and monitor progression.

Socioeconomic Status (SES): A composite measure encompassing income, education, occupation and related resources that influence an individual’s social and economic position.

Social Determinants of Health: Non-medical factors—such as housing, education, socioeconomic policies and community environment—that shape health outcomes and disparities.

References

1. Income Level and Impaired Kidney Function Among Working Adults in Japan. JAMA Health Forum (2024).
2. Deprivation and chronic kidney disease—a review of the evidence. Clinical Kidney Journal (2023).
3. Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review. BMC Nephrology (2020).