Table 4.
Association of PS indicators (negative life events, discrimination, stress at work/home and depressive symptoms) with albuminuria, reduced eGFR and CKD risk among rural and urban Ghana
| 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 | |||||||||
| Urban Ghana | |||||||||
| No | 477 (11.9) | 1.00 (Reference) | 1.00 (Reference) | 477 (4.4) | 1.00 (Reference) | 1.00 (Reference) | 477 (12.2) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 912 (10.5) | 0.87 (0.61 to 1.23) | 0.87 (0.61 to 1.24) | 911 (3.4) | 0.73 (0.41 to 1.31) | 0.72 (0.40 to 1.29) | 910 (10.8) | 0.87 (0.61 to 1.24) | 0.87 (0.61 to 1.25) |
| Rural Ghana | |||||||||
| No | 255 (7.5) | 1.00 (Reference) | 1.00 (Reference) | 259 (4.6) | 1.00 (Reference) | 1.00 (Reference) | 255 (8.6) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 683 (7.6) | 0.97 (0.56 to 1.69) | 0.94 (0.54 to 1.64) | 690 (3.5) | 0.63 (0.31 to 1.31) | 0.66 (0.32 to 1.37) | 680 (8.8) | 0.93 (0.55 to 1.58) | 0.92 (0.54 to 1.56) |
| Discrimination | |||||||||
| Urban Ghana | |||||||||
| No | 1326 (11.1) | 1.00 (Reference) | 1.00 (Reference) | 1326 (3.9) | 1.00 (Reference) | 1.00 (Reference) | 1325 (11.4) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 71 (8.5) | 0.85 (0.36 to 2.00) | 0.89 (0.37 to 2.11) | 71 (2.8) | 1.17 (0.27 to 2.09) | 1.16 (0.27 to 2.06) | 71 (7.1) | 0.69 (0.27 to 1.77) | 0.72 (0.28 to 1.83) |
| Rural Ghana | |||||||||
| No | 708 (8.1) | 1.00 (Reference) | 1.00 (Reference) | 721 (3.9) | 1.00 (Reference) | 1.00 (Reference) | 706 (9.2) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 33 (6.1) | 0.79 (0.18 to 3.47) | 0.84 (0.19 to 2.65) | 33 (0.0) | * | * | 33 (6.1) | 0.75 (0.17 to 2.89) | 0.83 (0.19 to 2.65) |
| Stress at home/work | |||||||||
| Urban Ghana | |||||||||
| Never | 460 (10.9) | 1.00 (Reference) | 1.00 (Reference) | 460 (3.3) | 1.00 (Reference) | 1.00 (Reference) | 460 (10.2) | 1.00 (Reference) | 1.00 (Reference) |
| Some stress | 732 (11.5) | 1.04 (0.71 to 1.51) | 0.91 (0.62 to 1.37) | 730 (4.1) | 1.27 (0.66 to 2.43) | 1.30 (0.67 to 2.51) | 730 (11.8) | 1.13 (0.77 to 1.65) | 1.04 (0.71 to 1.53) |
| Several/Permanent stresses | 197 (9.6) | 0.87 (0.50 to 1.52) | 0.74 (0.42 to 1.02) | 198 (3.5) | 1.17 (0.46 to 2.84) | 1.20 (0.47 to 3.09) | 197 (11.7) | 1.15 (0.68 to 1.71) | 1.05 (0.61 to 1.81) |
| Rural Ghana | |||||||||
| Never | 222 (9.0) | 1.00 (Reference) | 1.00 (Reference) | 228 (3.5) | 1.00 (Reference) | 1.00 (Reference) | 222 (9.5) | 1.00 (Reference) | 1.00 (Reference) |
| Some stress | 547 (6.9) | 0.69 (0.39 to 1.23) | 0.68 (0.38 to 1.22) | 549 (3.6) | 0.88 (0.38 to 2.07) | 0.92 (0.39 to 2.18) | 544 (8.3) | 0.74 (0.42 to 1.30) | 0.75 (0.42 to 1.31) |
| Several/Permanent stresses | 168 (7.1) | 0.63 (0.30 to 1.37) | 0.60 (0.28 to 1.29) | 171 (4.7) | 1.07 (0.38 to 3.03) | 1.21 (0.43 to 3.46) | 168 (8.9) | 0.71 (0.34 to 1.50) | 0.73 (0.35 to 1.50) |
| Depressive symptoms | |||||||||
| Urban Ghana | |||||||||
| No | 1336 (11.3) | 1.00 (Reference) | 1.00 (Reference) | 1335 (3.8) | 1.00 (Reference) | 1.00 (Reference) | 1334 (11.5) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 52 (3.9) | 0.30 (0.07 to 1.25) | 0.30 (0.07 to 1.27) | 52 (1.9) | 0.46 (0.06 to 2.50) | 0.45 (0.06 to 2.13) | 52 (5.8) | 0.44 (0.14 to 1.45) | 0.45 (0.14 to 1.48) |
| Rural Ghana | |||||||||
| No | 876 (7.7) | 1.00 (Reference) | 1.00 (Reference) | 887 (3.8) | 1.00 (Reference) | 1.00 (Reference) | 873 (8.7) | 1.00 (Reference) | 1.00 (Reference) |
| Yes | 62 (6.5) | 0.67 (0.23 to 1.94) | 0.67 (0.23 to 1.94) | 62 (3.2) | 0.58 (0.13 to 2.56) | 0.61 (0.14 to 2.68) | 62 (9.7) | 0.82 (0.33 to 2.01) | 0.85 (0.34 to 2.09) |
Model 1, adjusted for age and sex; model 2, adjusted for age, sex and educational level.
*No case of CKD and therefore ORs were not calculated.
ACR, albumin creatinine ration; eGFR, estimated glomerular filtration rate; CKD, chronic kidney disease; K DIGO, Kidney Disease: Improving Global Outcomes; n, total number of Ghanaians living in urban and rural Ghana among the various levels of PS constructs; PS, psychosocial stressors; %, proportion of individuals with CKD among the various levels of PS constructs in rural and urban Ghana.