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Abstract: TH-PO0983

Association of Social Needs Burden with CKD Severity in an Urban Population

Session Information

Category: Diversity and Equity in Kidney Health

  • 900 Diversity and Equity in Kidney Health

Authors

  • Della Croce, Rebecca, Albert Einstein College of Medicine, Bronx, New York, United States
  • Fisher, Molly, Albert Einstein College of Medicine, Bronx, New York, United States
  • Melamed, Michal L., New York University Grossman School of Medicine, New York, New York, United States
  • Johns, Tanya S., Albert Einstein College of Medicine, Bronx, New York, United States
Background

Emerging evidence indicates that unmet social needs—such as food or housing insecurity—may contribute to CKD risk beyond that of traditional risk factors. However, the association of multiple concurrent social needs with CKD severity is not well understood.

Methods

We conducted a cross-sectional study of adults (≥18 years) with CKD who completed a social risk screener during primary care visits at a large urban health system between 1/1/21 and 6/30/24. The 10-item screener, adapted from the Health Leads questionnaire, assessed needs related to housing, food, transportation, finances, utilities, dependent care, legal issues, relationship stress, and interpersonal safety. CKD diagnosis and stage was determined by ICD-10 codes and the eGFR closest to the screener date; patients with ESKD or prior transplant were excluded. Logistic regression models estimated the association between social needs burden (0, 1–2, ≥3) and severity of CKD (eGFR < 60 vs. ≥ 60 mL/min/1.73m2), adjusting for demographics, comorbidities, medications, insurance, language, and area-level Social Deprivation Index (SDI).

Results

Of 857 patients, the mean age was 69.9 years; 58% were female, 85% self-identified as Black or Hispanic, 13% reported ≥ 1 social need, and 65% had an eGFR < 60 mL/min/1.73m2. Patients with more social needs were younger, more often publicly insured, and lived in areas with higher SDI. No significant association was found between high social needs burden (≥3) and more severe CKD after multivariable adjustment (OR 1.34; 95% CI 0.48- 3.76). However, the need for dependent care was independently associated with more severe CKD (OR 4.12; 95% CI 1.31-13.17).

Conclusion

In this CKD cohort, many patients had unmet social needs, supporting routine social risk screening. While overall social needs burden was not significantly associated with more severe CKD, need for dependent care showed a strong association and warrants further study.

Digital Object Identifier (DOI)