Kidney Week

Abstract: SA-PO852

Improving Care by Targeting High-Risk Communities in North Carolina (NC)

Session Information

• CKD: Socioeconomic Context and Mobile Apps
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2101 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Jain, Koyal, UNC Kidney Center, Chapel Hill, North Carolina, United States

Koyal Jain,

• Powell, Jill, UNC Kidney Center, Chapel Hill, North Carolina, United States

Jill Powell,

• Poulton, Caroline J., UNC Kidney Center, Chapel Hill, North Carolina, United States

Caroline J. Poulton,

• Gibson, Keisha L., UNC Kidney Center, Chapel Hill, North Carolina, United States

Keisha L. Gibson,

• Falk, Ronald J., UNC Kidney Center, Chapel Hill, North Carolina, United States

Ronald J. Falk,

• Kshirsagar, Abhijit V., University of North Carolina, Chapel Hill, North Carolina, United States

Abhijit V. Kshirsagar,

• Hogan, Susan L., University of North Carolina, Chapel Hill, North Carolina, United States

Susan L. Hogan,

Background

Nearly one million in NC have chronic kidney disease (CKD), not including end-stage kidney disease. A goal of the UNC Kidney Center’s Kidney Education and Outreach Program (KEOP) is to understand potential healthcare barriers faced by rural communities. The objective of this study was to describe characteristics of screening participants and their access to physician care.

Methods

The KEOP conducted 206 screenings, predominantly in rural communities, collecting urinalysis and surveys (10/2005-11/2015). This exploratory data analysis compared participants who had seen their regular doctor in the past year to those without a regular doctor or who had not seen one in over a year. Characteristics examined included, age, gender, race, diabetes (DM), hypertension (HTN), income status and others. Proteinuria was assessed by dipstick (negative, trace, 1+, 2+, and 3+).

Results

5512 were screened; 53% were Black, 55% and 26% had HTN and DM, respectively. 8% had > trace proteinuria, among whom 92% were unaware of a kidney problem, and 50% fell below the NC poverty line. 18% reported not having a regular physician or not seeing a provider for >1 year (Figure); and although younger, reported a worrisome presence of DM (13%) and HTN (30%), with 45% reporting no health insurance and 20% Hispanic.

Conclusion

NC is the 9^th largest state; 40% rural. It is abysmal that nearly 1-in-5 screened reported no regular medical care despite having common CKD risk factors. Community medical resources in rural NC were unavailable or under-utilized. Obviating financial and language barriers is critical to connect this high-risk group to chronic disease care.

Figure