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Kidney Week

Abstract: PO0476

Association of Health-Related Social Needs with Kidney Protective Measures in an Urban Population

Session Information

Category: CKD (Non-Dialysis)

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

Authors

  • Novick, Tessa Kimberly, University of Texas at Austin Dell Medical School, Austin, Texas, United States
  • Han, Dingfen, Johns Hopkins University, Baltimore, Maryland, United States
  • Jacobs, Elizabeth A., University of Texas at Austin Dell Medical School, Austin, Texas, United States
  • Evans, Michele Kim, National Institute on Aging, Bethesda, Maryland, United States
  • Zonderman, Alan B., National Institute on Aging, Bethesda, Maryland, United States
  • Crews, Deidra C., Johns Hopkins University, Baltimore, Maryland, United States
Background

Health-related social needs are individual-level social determinants of health, such as food insecurity and housing insecurity. Maintaining blood pressure ≤130/80 mmHg, hemoglobin a1c ~7%, sodium intake <2 g/day, regular physical activity, BMI 20-25 kg/m2, and smoking cessation reduce risk of CKD and CKD progression. We evaluated whether having unmet needs was associated with achieving kidney protective measures.

Methods

We performed a cross-sectional analysis of data from the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (Baltimore, MD) during study visit 4. We used multivariable regression to quantify associations between having and least one unmet social need (food insecurity or housing insecurity), and the number of protective measures met (BP ≤130/80 mmHg, a1c 6.5-7.5%, daily sodium intake <2g, BMI 20-25 kg/m2, physical activity, non-smoker), and each measure independently.

Results

Among 1805 HANDLS participants, 899 (49.8%) reported at least one unmet health-related social need. Compared to those without unmet needs, those with unmet needs were younger (mean age 55.0 versus 57.8 years), more likely to be black (63.7% versus 58.5%), report income <125% of federal poverty level (46.8% versus 31.9%), and had higher eGFR (mean 90.0 versus 85.8 ml/min/1.73m2). The likelihood of achieving a higher number of protective measures was significantly lower for those with unmet needs compared to those without unmet needs (Table). Having unmet needs was significantly associated with lower likelihood of being a non-smoker and engaging in physical activity.

Conclusion

Individuals with unmet social needs may be less likely to achieve measures to prevent incident CKD and CKD progression.

Association Between Unmet Health-related Social Needs and Kidney Protective Measures
 Total # measuresBP ≤130/80 mmHgHgbA1c
6.5-7.5%
Sodium <2g/dayBMI
20-25 kg/m2
Physical activityNon-smoker
 IRR (95%CI)IRR (95%CI)RR (95%CI)IRR (95%CI)IRR (95%CI)RR (95%CI)IRR (95%CI)
Unadjusted0.87
(0.82-0.93)
0.99
(0.94-1.05)
0.90
(0.68-1.19)
0.81
(0.42-1.54)
1.13
(0.94-1.36)
0.72
(0.63-0.83)
0.73
(0.68-0.79)
Adjusted*0.90
(0.84-0.96)
1.00
(0.95-1.05)
0.97
(0.73-1.28)
0.92
(0.46-1.86)
1.11
(0.92-1.35)
0.72
(0.63-0.83)
0.79
(0.73-0.86)

*Fully adjusted models adjusted for age, race, sex, income above/below 125% federal poverty level, urine albumin-creatinine ratio, estimated glomerular filtration rate. **BP – blood pressure; HgbA1c – hemoglobin A1c; BMI – body mass index; IRR – incidence rate ratio; RR – risk ratio; CI – confidence interval