Socioeconomic Inequities in Early Kidney Care Concentrate at Late Initial Clinical Detection Rather Than Planned Care: A Population-Based Study

Deprived households in adults in North-East Scotland (2011–2020) are linked to later clinical presentation at first detection of CKD (eGFR <60 mL/min/1.73 m^2), with adjusted RR 1.69 (95% CI 1.48–1.93).

• Why it matters: It is unclear whether socioeconomic gaps in CKD outcomes emerge before diagnosis or during management, which determines whether post-diagnosis care changes can reduce disparities.
• What they did: A population-based cohort of 44,252 adults linked healthcare and Census data and modeled sequential early kidney care steps from initial clinical detection, estimating adjusted risk ratios with modified Poisson models.
• The result: Late presentation at detection is associated with higher mortality (adjusted HR 1.78, 1.70–1.87), persisting beyond the first year, implying disparities concentrate at or before recognition.

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