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Kidney Week

Abstract: SA-PO062

Impact of Social Determinants of Health on the Prevalence of CKD in Jalisco, Mexico

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Romero, Alexia, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • De la Torre Quiroga, Andres E., Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • Garcia-Garcia, Guillermo, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • Chavez, Jonathan, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • Gómez Fregoso, Juan, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • Calderon Garcia, Clementina Elizabeth, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
  • Arizaga Napoles, Manuel, Hospital Civil de Guadalajara, Guadalajara, Jalisco, Mexico
Background

Social determinants of health have been linked with disparities on the incidence and prevalence of CKD. In Mexico, CKD has become an important public health problem; current guidelines recommend routine CKD testing in patients at increased risk. We report the impact of social determinants of health on the prevalence of chronic kidney disease in Jalisco.

Methods

Between 2006-2019 we screened people at risk for the presence of CKD using mobile units that traveled to rural and urban communities of Jalisco. Trained personnel collected demographic and clinical data and obtained blood and urine for serum chemistry and dipstick urinalysis. Individuals who were aware they had kidney disease were not assessed; all others were eligible to participate. GFR was estimated with the EPI-CKD formula. CKD was defined as an eGFR < 60 ml/min/1.73 m2.

Results

Between 2016-2019, 63,918 individuals were evaluated. Findings in individuals with CKD and without it were compared. CKD was more prevalent among individuals without schooling (p=< 0.001), homelessness (p=0.003), unemployed (p< 0.001) and lacking health care insurance (p<0.001) (Table 1). By multivariate analysis, illiteracy (OR 1.10, 95% CI 1.01-1.21, p=0.04) and lack of health care insurance (OR 1.12, 95% CI 1.04-1.19, p 0.001) independently increased the risk of CKD.

Conclusion

Social determinants of health were associated with a greater prevalence of CKD in our population. Our findings suggest that interventions addressing the social determinant factors are needed in individuals with CKD.

Table 1.- Demographics characteristics of the participants.
 CKD
n = 5,868
n (%)
no-CKD
n = 58,050
n (%)
p
Age (years)65.9 ±13.448.6 ±14.4<0.001
Female gender4,340 (74.0%)36,914 (63.6%)<0.001
DM 1,868 (31.8%)10,232 (17.6%)<0.001
HTA3,146 (53.6%)14,645 (25.2%)<0.001
eGFR (ml/min/1.73m2)48.9 (11.2)88.0 (16.0)<0.001
Illiterate792 (13.5%)2,689(4.6%)<0.001
Homeless105 (1.8%)763 (1.3%)0.003
Unemployed3,075 (52.4%)19,695 (33.9%)<0.001
Uninsured1,684 (28.7%)13,663 (23.5%)<0.001