Kidney Week

Abstract: TH-PO1060

Functional and Biochemical Status of Uninsured Patients Starting Kidney Replacement Therapy

Session Information

• CKD: Epidemiology, Risk Factors, and Other Conditions
  November 06, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Gamez, Ariadna Selene Ramirez, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico

Ariadna Selene Ramirez Gamez

• Perez-Navarro, L. Monserrat, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico

L. Monserrat Perez-Navarro, PhD, MPH

• Galicia, Viridiana Galicia, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico

Viridiana Galicia Galicia, MD

• Reyes, Karina Elizabeth, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico

Karina Elizabeth Reyes, MD

• Joffre Torres, Aranza, Hospital General de Mexico Dr Eduardo Liceaga, Mexico City, CDMX, Mexico

Aranza Joffre Torres, MD

Background

In Mexico, the prevalence of chronic kidney disease (CKD) reached 9,184.9 per 100,000 inhabitants in 2021. Diabetes was the primary cause, and CKD-related mortality remained high. In 2022, the National Council for the Evaluation of Social Development Policy (CONEVAL) reported that 64.7 million people lacked access to social security. This scenario leads to delayed initiation of renal replacement therapy (RRT), often under urgent circumstances, with consequences for patients’ functional and biochemical status.

Methods

Objective: To assess the physical functional and biochemical status of uninsured patients at the time of late initiation of RRT.

This cross-sectional study included 165 patients who began RRT via urgent dialysis. Functional assessment included bioimpedance, handgrip dynamometry, and standardized evaluations using the Katz Index, Lawton-Brody scale, and the Short Physical Performance Battery (SPPB).

Results

Of the total number of patients, 85% initiated RRT with hemodialysis, (Table 1). All patients showed fluid overload, with an average extracellular water percentage of 36%. In terms of functional independence, 43% had high dependence, 20% moderate dependence, and 37% were independent based on Katz and Lawton-Brody scores. Regarding physical performance (SPPB), 42.7% demonstrated severe physical limitations (Figure 1). All patients exhibited sarcopenia according to handgrip strength criteria. The mean estimated glomerular filtration rate (eGFR) at the time of initiation was 4 mL/min/1.73 m², and 10% of patients had severe anemia.

Conclusion

Uninsured patients tend to start RRT late, often in poor general condition. The lack of timely medical care is associated with high dependency levels, sarcopenia, and severe functional impairment. These findings underscore the need for improved early detection and access to nephrological care in vulnerable populations.

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025a8ryp6zj