Abstract: FR-PO0045
Health-Related Social Needs and Risk Factors for AKI
Session Information
- AKI: Epidemiology, Risk Factors, and Prevention
November 07, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- McGredy, Maxine, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Ishigami, Junichi, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
- Bitzel, Jack, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Thiessen Philbrook, Heather, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Menez, Steven, Johns Hopkins Medicine, Baltimore, Maryland, United States
- Parikh, Chirag R., Johns Hopkins Medicine, Baltimore, Maryland, United States
Background
Adverse health-related social needs (HRSNs) disproportionately affect kidney health and may increase the risk of AKI during hospitalization. In 2024, the Center for Medicare and Medicaid Services (CMS) implemented a mandatory screening for HRSNs for all hospitalized patients. We examined the prevalence of specific HRSNs and their association with AKI development within a large healthcare system.
Methods
We analyzed data from the first hospitalization of 48,822 patients admitted to the Johns Hopkins Hospital from January 1-December 31, 2024. HRSNs were assessed via patient self-report and included 5 domains: food insecurity, housing instability, transportation needs, utility needs, and interpersonal safety. Each HRSN was treated as a binary variable (at risk or not at risk). We employed multivariable logistic regression models to estimate the adjusted odds ratios (ORs) for developing AKI in patients at risk of HRSNs compared to those not at risk. AKI was defined as serum creatinine increase >0.3mg/dL in 48 hours or creatinine increase >1.5 times calculated outpatient baseline within the prior 7 days.
Results
Of the 48,822 patients, 9,416 (19.3%) developed AKI. Compared to those without AKI, the at risk prevalence for food insecurity (10.9% vs. 9.4%), transportation needs (6.8% vs. 5.9%), and utility needs (3.7% vs. 3.3%) was higher in those with AKI. In multivariable logistic regression, food insecurity, and transportation needs were significantly associated with 12% to 17% higher odds of AKI development (Table). Among patients who responded to all five domains (n=23,557), we observed a dose-response relationship, with additional 4% odds of developing AKI with each additional HRSN reported (OR 1.04 [95%CI, 1.0-1.09]).
Conclusion
Among hospitalized patients, HRSNs such as food insecurity, transportation needs, and utility needs were each significantly associated with an increased risk of AKI, with the risk increasing with the number of HRSNs. Future research into mechanisms underlying these risk factors may help prevent AKI.
Funding
- NIDDK Support