Association between socioeconomic status and academic performance in children and adolescents with chronic kidney disease

Abstract

Background: Lower socioeconomic status (SES) is associated with lower academic achievement; however, this relationship is understudied in children with chronic kidney disease (CKD). This study examined the relationship between SES and academic performance in children and adolescents with CKD. Methods: A total of 377 participants aged 6–18 years with CKD stages 1–5 (n = 199), on dialysis (n = 43) or with a kidney transplant (n = 135) were recruited. Five SES measures and a composite SES index were examined for associations with parent-rated average or above average academic performance in numeracy and literacy using multivariable logistic regression. Results: Participants’ median age was 12.6 years (IQR 8.9–15.5). Adjusted odds ratios (aOR) (95%CI) for better performance in numeracy and literacy, respectively, were 0.71 (0.44–1.15) and 0.75 (0.45–1.23) for children whose caregivers had lower educational attainment; 0.46 (0.26–0.80) and 0.53 (0.30–0.93) for lower household income; 0.52 (0.32–0.85) and 0.44 (0.26–0.73) for caregivers who were unemployed; 0.68 (0.41–1.12) and 0.59 (0.35–1.00) for caregivers with poor self-rated financial status; and 0.93 (0.53–1.64) and 1.00 (0.56–1.79) for caregivers who did not own their own home. Compared with the highest SES index quartile, the aORs for better performance by SES quartile in descending order were 1.24 (0.60–2.54), 0.76 (0.37–1.58), and 0.39 (0.18–0.86) for numeracy and 0.88 (0.41–1.85), 0.77 (0.35–1.66), and 0.32 (0.14–0.72) for literacy. No interactions were identified between SES and CKD stage, child age, or gender. Conclusions: Across all CKD stages, children from lower SES families are less likely to perform well in literacy and numeracy than those from higher SES households. Graphical abstract: A higher resolution version of the Graphical abstract is available as Supplementary information [Figure not available: see fulltext.]