{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T14:45:07Z","timestamp":1786373107147,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2018,2]]},"abstract":"\n Background and objectives<\/jats:title>\n Established risk factors for CKD do not fully account for risk of CKD in black Americans. We studied the association of nondepressive psychosocial factors with risk of CKD in the Jackson Heart Study.<\/jats:p>\n <\/jats:sec>\n \n Design, setting, participants, & measurements<\/jats:title>\n We used principal component analysis to identify underlying constructs from 12 psychosocial baseline variables (perceived daily, lifetime, and burden of lifetime discrimination; stress; anger in; anger out; hostility; pessimism; John Henryism; spirituality; perceived social status; and social support). Using multivariable models adjusted for demographics and comorbidity, we examined the association of psychosocial variables with baseline CKD prevalence, eGFR decline, and incident CKD during follow-up.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 3390 (64%) Jackson Heart Study participants with the required data, 656 (19%) had prevalent CKD. Those with CKD (versus no CKD) had lower perceived daily (mean [SD] score =7.6 [8.5] versus 9.7 [9.0]) and lifetime discrimination (2.5 [2.0] versus 3.1 [2.2]), lower perceived stress (4.2 [4.0] versus 5.2 [4.4]), higher hostility (12.1 [5.2] versus 11.5 [4.8]), higher John Henryism (30.0 [4.8] versus 29.7 [4.4]), and higher pessimism (2.3 [2.2] versus 2.0 [2.1]; all\n P<\/jats:italic>\n <0.05). Principal component analysis identified three factors from the 12 psychosocial variables: factor 1, life stressors (perceived discrimination, stress); factor 2, moods (anger, hostility); and, factor 3, coping strategies (John Henryism, spirituality, social status, social support). After adjustments, factor 1 (life stressors) was negatively associated with prevalent CKD at baseline among women only: odds ratio, 0.76 (95% confidence interval, 0.65 to 0.89). After a median follow-up of 8 years, identified psychosocial factors were not significantly associated with eGFR decline (life stressors:\n \u03b2<\/jats:italic>\n =0.08; 95% confidence interval, \u22120.02 to 0.17; moods:\n \u03b2<\/jats:italic>\n =0.03; 95% confidence interval, \u22120.06 to 0.13; coping:\n \u03b2<\/jats:italic>\n =\u22120.02; 95% confidence interval, \u22120.12 to 0.08) or incident CKD (life stressors: odds ratio, 1.07; 95% confidence interval, 0.88 to 1.29; moods: odds ratio, 1.02; 95% confidence interval, 0.84 to 1.24; coping: odds ratio, 0.91; 95% confidence interval, 0.75 to 1.11).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Greater life stressors were associated with lower prevalence of CKD at baseline in the Jackson Heart Study. However, psychosocial factors were not associated with risk of CKD over a median follow-up of 8 years.<\/jats:p>\n <\/jats:sec>\n \n Podcast<\/jats:title>\n This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2018_01_03_CJASNPodcast_18_2_L.mp3<\/jats:p>\n <\/jats:sec>","DOI":"10.2215\/cjn.06430617","type":"journal-article","created":{"date-parts":[[2018,1,3]],"date-time":"2018-01-03T20:20:37Z","timestamp":1515010837000},"page":"213-222","source":"Crossref","is-referenced-by-count":17,"title":["Nondepressive Psychosocial Factors and CKD Outcomes in Black Americans"],"prefix":"10.2215","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9350-320X","authenticated-orcid":false,"given":"Joseph","family":"Lunyera","sequence":"first","affiliation":[{"name":"Divisions of General Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3875-7466","authenticated-orcid":false,"given":"Clemontina A.","family":"Davenport","sequence":"additional","affiliation":[{"name":"Divisions of General Internal Medicine and"},{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nrupen A.","family":"Bhavsar","sequence":"additional","affiliation":[{"name":"Divisions of General Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Sims","sequence":"additional","affiliation":[{"name":"Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1707-691X","authenticated-orcid":false,"given":"Julia","family":"Scialla","sequence":"additional","affiliation":[{"name":"Nephrology and"},{"name":"Duke Clinical Research Institute, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5169-8371","authenticated-orcid":false,"given":"Jane","family":"Pendergast","sequence":"additional","affiliation":[{"name":"Divisions of General Internal Medicine and"},{"name":"Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3057-4828","authenticated-orcid":false,"given":"Rasheeda","family":"Hall","sequence":"additional","affiliation":[{"name":"Nephrology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal C.","family":"Tyson","sequence":"additional","affiliation":[{"name":"Nephrology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer St. Clair","family":"Russell","sequence":"additional","affiliation":[{"name":"Divisions of General Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Correa","sequence":"additional","affiliation":[{"name":"Jackson Heart Study, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Ebony","family":"Boulware","sequence":"additional","affiliation":[{"name":"Divisions of General Internal Medicine and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8212-6288","authenticated-orcid":false,"given":"Clarissa J.","family":"Diamantidis","sequence":"additional","affiliation":[{"name":"Divisions of General Internal Medicine and"},{"name":"Nephrology and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,1,3]]},"reference":[{"key":"B1-20230813","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1001\/jama.298.17.2038","article-title":"Prevalence of chronic kidney disease in the United States.","volume":"298","author":"Coresh","year":"2007","journal-title":"JAMA"},{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJMoa041031","article-title":"Chronic kidney disease and the risks of death, cardiovascular events, and 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