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Kidney Week

Abstract: FR-OR84

Association of Unmet Social Determinants of Health (SDOH) with Quality of Life (QoL) in Patients on Hemodialysis (HD)

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Wen, Huei Hsun, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Dai, Yang, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Nadkarni, Girish N., Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Chan, Lili, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background

Patients on hemodialysis (HD) have low quality of life (QoL). Social determinants of health (SDOH) are the non-medical aspects of a patient’s life that affect their health. Whether unmet SDOH are associated with QoL in patients on HD has not previously been studied.

Methods

We prospectively surveyed patients on their living situation, food security, transportation, utilities, and safety using the AHC-HRSN and their QoL using the KDQOL-36. From the KDQOL-36, we calculated the physical component score (PCS), mental component score (MCS), and scores for effect, burden, and symptoms of kidney disease. Patients were included if they were over the age of 18, had been on HD for more than 30 days, and was able to complete the surveys with minimal assistance. Patients completed the surveys during their HD treatments. Laboratory values of hemoglobin, albumin, calcium, phosphorus, intact parathyroid hormone, and Kt/V were obtained from the monthly blood work closest to the survey administration. QoL scores were compared using Student’s T-test. We used linear regression to evaluate the association between SDOH and QoL while adjusting for age and gender.

Results

A total of 138 patients participated in the study, 53% were female, 50% were Black, and 43% were Hispanic. Unmet SDOH were common in our patients, with 40% of patients reporting food insecurity and 23% of patients reporting housing insecurity (Figure 1A). Patients with unmet SDOH had lower scores for PCS and MCS, and higher scores for effect, burden, and symptoms of kidney disease, although these were not statistically significant (Figure 1B&C). There was no clinically or statistically significant difference in laboratory values between patients with and without unmet SDOH. There was no significant association between SDOH measures and the PCS or MCS of the KDQOL-36.

Conclusion

Unmet SDOH are common in patients on HD, particularly food and housing insecurity. Patients with unmet SDOH report lower QoL and higher effect, burden, and symptoms of kidney disease. While not statistically significant, this may be related to a small sample size.

Funding

  • NIDDK Support