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Health literacy was assessed with the Short Test of Functional Health Literacy in Adults (dichotomized as limited\/adequate). Cox proportional hazards models were used to separately examine the relations of health literacy with CKD progression, cardiovascular event (any of the following: myocardial infarction, congestive heart failure, stroke or peripheral artery disease), and all-cause, cardiovascular and non-cardiovascular mortality. Poisson regression was used to assess the health literacy\u2013hospitalization association. Models were sequentially adjusted: Model 1 adjusted for potential confounders (sociodemographic factors), while Model 2 additionally adjusted for potential mediators (clinical and lifestyle factors) of the associations of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In confounder-adjusted models, participants with limited (vs adequate) health literacy [555 (15%)] had an increased risk of CKD progression [hazard ratio (HR) 1.34; 95% confidence interval (CI) 1.06\u20131.71], cardiovascular event (HR 1.67; 95% CI 1.39\u20132.00), hospitalization (rate ratio 1.33; 95% CI 1.26\u20131.40), and all-cause (HR 1.54; 95% CI 1.27\u20131.86), cardiovascular (HR 2.39; 95% CI 1.69\u20133.38) and non-cardiovascular (HR 1.27; 95% CI 1.01\u20131.60) mortality. Additional adjustments for potential mediators (Model 2) showed similar results except that the relations of health literacy with CKD progression and non-cardiovascular mortality were no longer statistically significant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the CRIC Study, adults with limited (vs adequate) health literacy had a higher risk for CKD progression, cardiovascular event, hospitalization and mortality\u2014regardless of adjustment for potential confounders.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ndt\/gfac201","type":"journal-article","created":{"date-parts":[[2022,6,24]],"date-time":"2022-06-24T05:48:06Z","timestamp":1656049686000},"page":"904-912","source":"Crossref","is-referenced-by-count":14,"title":["Prospective associations of health literacy with clinical outcomes in adults with CKD: findings from the CRIC study"],"prefix":"10.1093","volume":"38","author":[{"given":"Mayra L","family":"Estrella","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health , Brownsville, TX , USA"},{"name":"Institute for Minority Health Research, University of Illinois at Chicago , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Allen-Meares","sequence":"additional","affiliation":[{"name":"Institute for Minority Health Research, University of Illinois at Chicago , Chicago, IL , USA"},{"name":"Office of Health Literacy, University of Illinois at Chicago , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana C","family":"Ricardo","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Illinois at Chicago , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J","family":"Fischer","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Illinois at Chicago , Chicago, IL , USA"},{"name":"Medicine\/Nephrology, Jesse Brown VA Medical Center , Chicago, IL , USA"},{"name":"Center of Innovation for Complex Chronic Healthcare , Edward Hines Jr VA Hospital, Hines, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa J","family":"Gordon","sequence":"additional","affiliation":[{"name":"Division of Transplantation, Department of Surgery, Feinberg School of Medicine, Northwestern University , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunice","family":"Carmona-Powell","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, University of Illinois at Chicago , Chicago, IL , 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