The impact of social deprivation on development and progression of diabetic kidney disease

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dc.check.date2036-05-31
dc.check.infoControlled Access
dc.contributor.advisorKearney, Patricia M.
dc.contributor.advisorBuckley, Claire
dc.contributor.advisorexternalGriffin, Tomásen
dc.contributor.advisorexternalDinneen, Seanen
dc.contributor.advisorexternalGriffin, Matthewen
dc.contributor.authorCasey, Caoimheen
dc.contributor.funderNovo Nordisken
dc.date.accessioned2026-01-08T09:13:59Z
dc.date.available2026-01-08T09:13:59Z
dc.date.issued2025en
dc.date.submitted2025en
dc.descriptionControlled Access
dc.description.abstractBackground The prevalence of diabetes is rising, with 783 million people expected to be living with diabetes globally by 2045. Diabetic kidney disease (DKD) develops in up to 40% of people living with diabetes, and significantly increases morbidity and mortality. Social deprivation is well established as a risk factor for poorer health outcomes. Social deprivation is associated with increased prevalence of type 2 diabetes and an increased risk of complications in all types of diabetes. The impact of deprivation on DKD has been explored internationally, but there are very limited studies in Ireland in this area. The aim of this thesis was to explore the impact of social deprivation on the development and progression of DKD. Methods I carried out a systematic search of the literature across Europe on the association between deprivation and DKD. I examined some of the deprivation indices used as well as potential mechanisms behind the association and ways in which it may be addressed. I carried out a retrospective cohort study looking at the association between deprivation and DKD using a dataset of people attending a tertiary referral centre in Ireland. I used linear mixed effect models to calculate rate of decline in renal function using longitudinal estimated glomerular filtration rate (eGFR) data. I examined baseline clinical variables such as diabetes duration, smoking status, body mass index (BMI), systolic blood pressure (SBP), haemoglobin A1c (HbA1c), eGFR and low-density lipoprotein (LDL) cholesterol across socioeconomic categories. I then used linear and logistic regression models to examine the association between deprivation and rate of decline in renal function. Results The main findings in this thesis are: a) The literature demonstrates that there is a significant association between social deprivation and DKD, which can be partially explained by risk factors such as higher HbA1c and blood pressure in more deprived groups. b) I found significant differences in clinical variables across socioeconomic categories in my study. People in the more deprived groups had a higher BMI and SBP, a lower eGFR and were more likely to smoke compared with those in the least deprived groups. c) Using linear regression analysis, I demonstrated a significant association between deprivation and rate of decline in renal function, with attenuation of the association following adjustment for HbA1c, duration of diabetes, baseline eGFR, BMI, smoking, LDL cholesterol and SBP. Conclusions This thesis provides a comprehensive overview of deprivation and DKD as well as being the first study in Ireland and one of the few studies internationally, to explore the impact of social deprivation on rate of decline in renal function in diabetes. It suggests that the higher prevalence of risk factors for DKD in deprived populations may mediate the association between deprivation and progression of DKD and that targeted interventions to reduce risk factor burden may mitigate the effect of deprivation. It provides a base for future studies in Ireland in this area. This study and future studies will impact on public health strategies in Ireland and how we design care for diabetes and DKD.en
dc.description.statusNot peer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationCasey, C. 2025. The impact of social deprivation on development and progression of diabetic kidney disease. MRes Thesis, University College Cork.en
dc.identifier.endpage121en
dc.identifier.urihttps://hdl.handle.net/10468/18387
dc.language.isoenen
dc.publisherUniversity College Corken
dc.rights© 2025, Caoimhe Casey.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectDiabetes mellitusen
dc.subjectDiabetic kidney diseaseen
dc.subjectSocial deprivationen
dc.titleThe impact of social deprivation on development and progression of diabetic kidney diseaseen
dc.typeMasters thesis (Research)en
dc.type.qualificationlevelMastersen
dc.type.qualificationnameMRes - Master of Researchen
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