{"id":{"repo_id":"cork","oai_identifier":"oai:cora.ucc.ie:10468/18387"},"canonical_url":"https://search.dev.ndltd.org/etd/cork/oai:cora.ucc.ie:10468/18387","repository":{"repo_id":"cork","name":"University College Cork","base_url":"https://cora.ucc.ie/server/oai/request"},"display":{"title":"The impact of social deprivation on development and progression of diabetic kidney disease","abstract":"Background 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.","abstract_html":"Background 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.","abstract_has_math":false,"creators":["Casey, Caoimhe"],"institution":"University College Cork","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Kearney, Patricia M.","Buckley, Claire"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025","date_published":"2025","updated_at":"2026-07-24T01:46:44Z","subjects":["Diabetes mellitus","Diabetic kidney disease","Social deprivation"],"languages":["en"],"rights":["© 2025, Caoimhe Casey."],"rights_urls":["https://creativecommons.org/licenses/by/4.0/"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/10468/18387","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Kearney, Patricia M.","Buckley, Claire"]},{"key":"dc:creator","label":"Author","values":["Casey, Caoimhe"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2026-01-08T09:13:59Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2026-01-08T09:13:59Z"]},{"key":"dc:date.issued","label":"Date","values":["2025"]},{"key":"dc:publisher","label":"Institution","values":["University College Cork"]},{"key":"dc:type","label":"Dc Type","values":["Masters thesis (Research)"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters"]},{"key":"dc:type.qualificationname","label":"Dc Type Qualificationname","values":["MRes - Master of Research"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Diabetes mellitus","Diabetic kidney disease","Social deprivation"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language.iso","label":"Language (ISO)","values":["en"]},{"key":"dc:rights","label":"Dc Rights","values":["© 2025, Caoimhe Casey."]},{"key":"dc:rights.uri","label":"Rights URI","values":["https://creativecommons.org/licenses/by/4.0/"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/10468/18387"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["Controlled Access"]},{"key":"dc:description.abstract","label":"Abstract","values":["Background 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."]},{"key":"dc:format.mimetype","label":"Dc Format Mimetype","values":["application/pdf"]},{"key":"dc:title","label":"Title","values":["The impact of social deprivation on development and progression of diabetic kidney disease"]}]}],"canonical_facts":{"dc:contributor.advisor":["Kearney, Patricia M.","Buckley, Claire"],"dc:creator":["Casey, Caoimhe"],"dc:date.accessioned":["2026-01-08T09:13:59Z"],"dc:date.available":["2026-01-08T09:13:59Z"],"dc:date.issued":["2025"],"dc:description":["Controlled Access"],"dc:description.abstract":["Background 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."],"dc:format.mimetype":["application/pdf"],"dc:identifier.uri":["https://hdl.handle.net/10468/18387"],"dc:language.iso":["en"],"dc:publisher":["University College Cork"],"dc:rights":["© 2025, Caoimhe Casey."],"dc:rights.uri":["https://creativecommons.org/licenses/by/4.0/"],"dc:subject":["Diabetes mellitus","Diabetic kidney disease","Social deprivation"],"dc:title":["The impact of social deprivation on development and progression of diabetic kidney disease"],"dc:type":["Masters thesis (Research)"],"dc:type.qualificationlevel":["Masters"],"dc:type.qualificationname":["MRes - Master of Research"]},"updated_at":"2026-07-24T01:46:44Z"}