Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2016
Impact of Educational Attainment on Health Outcomes in Moderate to Severe CKD.
Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 64 citations in OpenAlex.
- HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis.The Cochrane database of systematic reviews · 2023Pooled it
- [Lifestyle pattern and therapeutic adherence in patients on hemodialysis].Revista medica del Instituto Mexicano del Seguro Social · 2026Trial
- The global epidemiology of acute kidney injury: challenges and opportunities.Nature reviews. Nephrology · 2026Review
- Association of cholesterol, high-density lipoprotein, and glucose (CHG) index with chronic kidney disease in Chinese community adults: findings from the REACTION study.Frontiers in nutrition · 2026Article
- CKD in Indigenous Populations in Kerala, India.Kidney international reports · 2026Article
- Educational attainment, body mass index, and smoking as mediators in kidney disease risk: a two-step Mendelian randomization study.Renal failure · 2025Article
- Prevalence and determinants of chronic kidney disease among HIV/AIDS patients in selected governmental hospitals at Addis Ababa, Ethiopia: a retrospective cross-sectional study.BMC infectious diseases · 2025Article
- Cardio-Renal-Metabolic Syndrome with Emphasis on Chronic Kidney Disease: Educational Attainment and Progression-A Retrospective Cohort Study.Healthcare (Basel, Switzerland) · 2025Article
- Incident chronic kidney disease among Canadian immigrants: a population-based cohort study.BMJ public health · 2024Article
- Socioeconomic Status and Clinical Outcomes in Chronic Kidney Disease: Bootstrap Validation of a Simple Indicator.Journal of clinical medicine · 2024Article
- The Challenge of Examining Social Determinants of Health in People Living With Tourette Syndrome.Pediatric neurology · 2024Article
- Overadjustment bias in systematic reviews and meta-analyses of socio-economic inequalities in health: a meta-research scoping review.International journal of epidemiology · 2024Article
- The Fruit and Veggies for Kidney Health Study: A Prospective Randomized Trial.Kidney medicine · 2023Article
- Inequities in kidney health and kidney care.Nature reviews. Nephrology · 2023Review
- Deprivation and chronic kidney disease-a review of the evidence.Clinical kidney journal · 2023Review
- Social determinants of health and the transition from advanced chronic kidney disease to kidney failure.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- The Association between Fear of Crime, Educational Attainment, and Health.Epidemiologia (Basel, Switzerland) · 2023Article
- Prospective associations of health literacy with clinical outcomes in adults with CKD: findings from the CRIC study.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2023Article
- Educational Attainment Is Associated With Kidney and Cardiovascular Outcomes in the German CKD (GCKD) Cohort.Kidney international reports · 2022Article
- Association between Educational Level and Physical Activity in Chronic Disease Patients of Eastern Slovakia.Healthcare (Basel, Switzerland) · 2021Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe inverse association between educational attainment and mortality is well established, but its relevance to vascular events and renal progression in a population with chronic kidney disease (CKD) is less clear. This study aims to determine the association between highest educational attainment and risk of vascular events, cause-specific mortality, and CKD progression. STUDY
designProspective epidemiologic analysis among participants in the Study of Heart and Renal Protection (SHARP), a randomized controlled trial. SETTING &
participants9,270 adults with moderate to severe CKD (6,245 not receiving dialysis at baseline) and no history of myocardial infarction or coronary revascularization recruited in Europe, North America, Asia, Australia, and New Zealand. PREDICTOR: Highest educational attainment measured at study entry using 6 levels that ranged from "no formal education" to "tertiary education." OUTCOMES: Any vascular event (any fatal or nonfatal cardiac, cerebrovascular, or peripheral vascular event), cause-specific mortality, and CKD progression during 4.9 years' median follow-up.
resultsThere was a significant trend (P<0.001) toward increased vascular risk with decreasing levels of education. Participants with no formal education were at a 46% higher risk of vascular events (relative risk [RR], 1.46; 95% CI, 1.14-1.86) compared with participants with tertiary education. The trend for mortality across education levels was also significant (P<0.001): all-cause mortality was twice as high among those with no formal education compared with tertiary-educated individuals (RR, 2.05; 95% CI, 1.62-2.58), and significant increases were seen for both vascular (RR, 1.84; 95% CI, 1.21-2.81) and nonvascular (RR, 2.15; 95% CI, 1.60-2.89) deaths. Lifestyle factors and prior disease explain most of the excess mortality risk. Among 6,245 participants not receiving dialysis at baseline, education level was not significantly associated with progression to end-stage renal disease or doubling of creatinine level (P for trend = 0.4). LIMITATIONS: No data for employment or health insurance coverage.
conclusionsLower educational attainment is associated with increased risk of adverse health outcomes in individuals with CKD.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.