Table 3.
Association of psychosocial stressors (PS) indicators (negative life events, discrimination, stress at work/home and depression) with albuminuria, reduced eGFR and CKD risk for Ghanaians living in Ghana and those living in Europe
| Albuminuria (ACR≥3 mg/mmol) | eGFR<60 mL/min/1.73 m2 | High-to-very high CKD risk (KDIGO, 2012) | |||||||
| n (%) | OR (95% CI) | n (%) | OR (95% CI) | n (%) | OR (95% CI) | ||||
| Model 1 | Model 2 | Model 1 | Model 2 | Model 1 | Model 2 | ||||
| Negative events | |||||||||
| Europe | |||||||||
| No | 1128 (8.2) | 1.00 (Reference) | 1.00 (Reference) | 1106 (2.6) | 1.00 (Reference) | 1.00 (Reference) | 1090 (8.5) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 1615 (8.4) | 1.03 (0.78 to 1.35) | 1.07 (0.80 to 1.42) | 1587 (2.5) | 0.86 (0.53 to 1.42) | 0.83 (0.49 to 1.39) | 1557 (8.6) | 0.97 (0.76 to 1.32) | 0.99 (0.74 to 1.32) |
| Ghana | |||||||||
| No | 732 (8.7) | 1.00 (Reference) | 1.00 (Reference) | 736 (4.5) | 1.00 (Reference) | 1.00 (Reference) | 732 (10.9) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 1595 (3.8) | 0.87 (0.65 to 1.16) | 0.85 (0.63 to 1.14) | 1601 (3.4) | 0.69 (0.45 to 1.08) | 0.67 (0.44 to 1.09) | 1590 (9.9) | 0.88 (0.66 to 1.17) | 0.86 (0.64 to 1.15) |
| Discrimination | |||||||||
| Europe | |||||||||
| No | 1899 (8.5) | 1.00 (Reference) | 1.00 (Reference) | 1867 (2.6) | 1.00 (Reference) | 1.00 (Reference) | 1832 (8.9) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 810 (7.4) | 0.87 (0.64 to 1.19) | 0.92 (0.67 to 1.26) | 791 (2.2) | 0.83 (0.47 to 1.47) | 0.84 (0.46 to 1.52) | 782 (7.3) | 0.82 (0.59 to 1.12) | 0.84 (0.60 to 1.16) |
| Ghana | |||||||||
| No | 2034 (10.0) | 1.00 (Reference) | 1.00 (Reference) | 2047 (3.9) | 1.00 (Reference) | 1.00 (Reference) | 2031 (10.6) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 104 (7.7) | 0.83 (0.39 to 1.73) | 0.91 (0.67 to 1.24) | 104 (1.9) | 0.67 (0.15 to 2.85) | 0.67 (0.16 to 2.84) | 104 (6.7) | 0.70 (0.32 to 1.55) | 0.71 (0.32 to 1.55) |
| Stress at home/work | |||||||||
| Europe | |||||||||
| Never | 1330 (8.2) | 1.00 (Reference) | 1.00 (Reference) | 1305 (3.4) | 1.00 (Reference) | 1.00 (Reference) | 1282 (8.5) | 1.00 (Reference) | 1.00 (Reference) |
| Some stress | 1002 (7.9) | 0.97 (0.72 to 1.31) | 1.04 (0.76 to 1.42) | 984 (1.4) | 0.47 (0.26 to 0.87) | 0.46 (0.24 to 0.88) | 968 (8.6) | 0.96 (0.71 to 1.30) | 1.02 (0.74 to 1.39) |
| Several/Permanent stresses | 397 (9.1) | 1.11 (0.74 to 1.64) | 1.153 (0.77 to 1.72) | 390 (2.3) | 0.73 (0.35 to 1.52) | 0.76 (0.36 to 1.61) | 383 (9.7) | 1.13 (0.77 to 1.68) | 1.19 (0.80 to 1.79) |
| Ghana | |||||||||
| Never | 682 (10.3) | 1.00 (Reference) | 1.00 (Reference) | 688 (3.3) | 1.00 (Reference) | 1.00 (Reference) | 682 (9.9) | 1.00 (Reference) | 1.00 (Reference) |
| Some stress | 1279 (9.5) | 0.87 (0.64 to 1.19) | 0.80 (0.59 to 1.11) | 1279 (3.9) | 1.06 (0.63 to 1.77) | 1.11 (0.66 to 1.87) | 1274 (10.3) | 0.95 (0.69 to 1.30) | 0.92 (0.67 to 1.26) |
| Several/Permanent stresses | 365 (8.5) | 0.75 (0.48 to 1.18) | 0.68 (0.59 to 1.11) | 369 (4.1) | 1.13 (0.57 to 2.23) | 1.22 (0.61 to 2.46) | 365 (10.4) | 0.96 (0.63 to 1.47) | 0.92 (0.59 to 1.42) |
| Depressive symptoms | |||||||||
| Europe | |||||||||
| No | 2505 (8.5) | 1.00 (Reference) | 1.00 (Reference) | 2457 (2.7) | 1.00 (Reference) | 1.00 (Reference) | 2416 (8.7) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 206 (6.3) | 0.71 (0.39 to 1.27) | 0.76 (0.43 to 1.36) | 202 (1.5) | 0.63 (0.19 to 2.03) | 0.68 (0.21 to 2.23) | 199 (7.1) | 0.78 (0.44 to 1.37) | 0.83 (0.47 to 1.46) |
| Ghana | |||||||||
| No | 2212 (9.9) | 1.00 (Reference) | 1.00 (Reference) | 2222 (3.8) | 1.00 (Reference) | 1.00 (Reference) | 2207 (10.4) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 114 (5.3) | 0.45 (0.19 to 1.03) | 0.45 (0.19 to 1.01) | 114 (2.6) | 0.52 (0.16 to 1.72) | 0.53 (0.17 to 1.74) | 114 (7.9) | 0.62 (0.30 to 1.25) | 0.61 (0.30 to 1.24) |
Model 1, adjusted for age and sex; model 2, adjusted for age, sex and educational level for Ghanaians (SSA) and length of stay for those in Europe.
The bold values are significant.
ACR, albumin creatinine ration; eGFR, estimated glomerular filtration rate; CKD, chronic kidney disease; KDIGO, Kidney Disease: Improving Global Outcomes; n, total number of Ghanaians living in Ghana and Europe among the various levels of PS constructs; SAA, sub-Saharan Africa; %, proportion of individuals with CKD among the various levels of PS constructs in Ghana and Europe