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Abstract: SA-PO357

Food Insecurity Is Associated with Short Stature, Slow Growth Velocity, and Lower Cognitive Function in the Chronic Kidney Disease in Children (CKiD) Cohort

Session Information

  • Pediatric Nephrology - III
    November 04, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Murphy, Margaret, University of Kentucky College of Medicine, Lexington, Kentucky, United States
  • Matheson, Matthew, Johns Hopkins University, Baltimore, Maryland, United States
  • Chishti, Aftab S., University of Kentucky College of Medicine, Lexington, Kentucky, United States
  • Kiessling, Stefan, University of Kentucky College of Medicine, Lexington, Kentucky, United States
  • Hooper, Stephen R., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
  • Warady, Bradley A., Children's Mercy Kansas City, Kansas City, Missouri, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Background

Food insecurity is defined as the state of being without reliable access to an adequate amount of affordable and nutritious food. Food insecurity is associated with disparities in chronic kidney disease in adults; however less is known in children.

Methods

The Chronic Kidney Disease in Children (CKiD) study is a multicenter, observational cohort of children with eGFR 30-90ml/min/1.73m2. Food insecurity screening was added in 2022 via the Hunger Vital screen. Cross-sectional analyses used Wilcoxon rank-sum test or Fisher’s exact test, as appropriate, to determine the association between food insecurity and disease outcomes related to growth and cognition.

Results

Of the 181 participants included, 9% of subjects (n=17) reported food insecurity. Food insecure subjects had a median age of 9.7 (IQR, 8.4-17.9), median GFR of 42 (IQR, 26, 66), 53% were male, and 18% had glomerular disease. Food insecure patients had a higher prevalence of short stature and lower growth velocity. None of these patients were on growth hormone; however, food insecure patients were significantly more likely to be seen by a nutritionist (p=0.003). Food insecure patients performed less well on IQ tests (mean 89 vs 102, p=0.03) and were from households with lower income and maternal education. Follow-up analyses found the effect of food insecurity on IQ to be independent of maternal education.

Conclusion

Children with CKD and food insecurity, which is frequently associated with lower household income, and lower maternal education, are more likely to present with impairments in growth and lower performance on IQ testing. This study highlights the need to screen for food insecurity as early identification and intervention may improve CKD-related health outcomes. Further analyses will investigate the impact of food insecurity on longitudinal outcomes of CKD progression and cardiovascular factors.

Funding

  • NIDDK Support