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Abstract: PO2496

Association of SNAP Benefit Use by Inner-City Kidney Transplant Recipients with Poorer Graft Function, Lower Fruit and Vegetable Intake, and Increased Psychosocial Stress

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Kasparov, Elizabeth G., SUNY Downstate Health Sciences University, Brooklyn, New York, United States
  • Cruickshank, Kingsley, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
  • Saleh, Ahmad, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
  • Pak, Soyeon, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
  • Markell, Mariana, SUNY Downstate Health Sciences University, Brooklyn, New York, United States
Background

Longterm kidney graft survival may be affected by factors other than biologic, including social determinants of health such as food scarcity and psychosocial stress.

Methods

A face-to-face survey was conducted in a random convenience sample of 31 pts in transplant clinic.The Stress and Social Support survey and the Perceived Stress Scale were used. Dietary intake was assessed using 24-hr recall and analyzed with ASA-24 software. All comparisons are by Chi square or t-test.

Results

There were 11 women(36%), 20 men(65%), 22 Black(71%). Mean age was 55.2±1.9 yrs, time since transplant 63.9±14.1 mos. 24 (77%) reported income <$40K, with 12 (39%)<$20K.12 (39%) recieved SNAP benefits (SNAP+). Income or employment rate did not differ for SNAP+ vs SNAP-. SNAP+ had significantly worse kidney function(creatinine 2.17±0.24 vs 1.44±0.11 mg/dl,p=0.014) and eGFR(37.9±3.8 vs 53.7±2.5 ml/min,p=0.003), but did not differ for time since transplant, gender, race, BP, BMI, tacrolimus level or age. SNAP+ also were more likely to disagree with the statement “I feel I am in control of my health and it doesn’t control me” (33% vs 0%, p=0.017),to report never or almost never feeling confident about handling personal problems(50% vs 16%, p=0.018),and to be unable to control irritations in their lives(67% vs 16%,p=0.043,p=0.043).No difference in caloric or macronutrient intake existed, but SNAP+ ate less fiber(11.1±1.3 vs 16.7±1.8 gm,p=0.023)and fewer servings of fruits/vegetables(1.5±0.28 vs 3.75±0.85, p=0.021).When asked about missed medication they did not report more missed doses.

Conclusion

In our patient population:1.Pts receiving SNAP had worse kidney function than those who did not despite similar time since transplant, tacrolimus level, income, and employment status.2.They ate less fiber and fewer servings of fruits/vegetables despite similar caloric intake, which should be investigated further as higher intake of fruit/vegetables is associated with delayed progression of kidney disease in non-transplant pts. 4..They also reported feeling less control over their health and less ability to handle daily stress. 4.These finding suggests that special attention should be paid to this population who have issues with social determinants that may affect kidney function.