Abstract: FR-PO0282
Acculturation and Risk of Death in US Hispanic Adults with CKD
Session Information
- CKD: Omics, Systemic Stressors, and Targeted Pharmacotherapy
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention
Authors
- Pineda, Madison T., University of Illinois Chicago, Chicago, Illinois, United States
- Missikpode, Celestin, University of Illinois Chicago, Chicago, Illinois, United States
- Lora, Claudia M., University of Illinois Chicago, Chicago, Illinois, United States
- Campos, Sinead M., University of Illinois Chicago, Chicago, Illinois, United States
- Ricardo, Ana C., University of Illinois Chicago, Chicago, Illinois, United States
- Lash, James P., University of Illinois Chicago, Chicago, Illinois, United States
Group or Team Name
- CRIC Study Group
Background
Lower acculturation has been associated with reduced mortality risk in some U.S. Hispanic populations, but this relationship has not been well studied in Hispanic adults with CKD.
Methods
Using data from 712 Hispanic participants in the Chronic Renal Insufficiency Cohort, we evaluated associations of two proxies of low acculturation (Spanish language preference [vs English] and non-US [vs US] born) with all-cause death (primary outcome), and end-stage kidney disease (ESKD), cardiovascular (CV) events (myocardial infarction, heart failure, stroke or peripheral arterial disease) and hospitalizations (secondary outcomes). Multivariable Cox proportional hazards and Poisson regression models were used for failure-time and event counts, respectively.
Results
Mean age was 58 years, 42% were female, and 67% had diabetes. Mean eGFR was 47.3 ml/min/1.73m2 and median proteinuria 0.5 g/24 hr. Compared to those with English language preference, those with Spanish preference were older, had a higher prevalence of diabetes, higher systolic BP, lower eGFR and higher proteinuria. Findings were similar when comparing US vs non-US born. Median follow-up time was 8.8 years. Multivariable results are shown in Table.
Conclusion
Despite having higher burden of risk factors, those with low acculturation experienced significantly lower risk of death and hospitalization. Future research is needed to better understand factors responsible for these paradoxical findings.
| Table 1a. Association between Language Preference and clinical outcomes* | |||||
| Outcomes | Events/n | Per 100 person-yrs | Unadjusted HR (95% CI) | Adjusted HR (95% CI) | |
| Death | English | 82/232 | 3.41 | Ref | Ref |
| Spanish | 180/480 | 3.91 | 1.12 (0.86, 1.46) | 0.66 (0.46, 0.95) | |
| ESKD | English | 73/232 | 3.85 | Ref | Ref |
| Spanish | 221/480 | 7.39 | 1.86 (1.43, 2.43) | 0.94 (0.65, 1.36) | |
| CV Event | English | 69/232 | 3.82 | Ref | Ref |
| Spanish | 136/480 | 4.22 | 1.04 (0.78, 1.39) | 0.96 (0.62, 1.48) | |
| Hospitalization | English | 1691/232 | 71.12 | Ref | Ref |
| Spanish | 2695/480 | 58.49 | 0.82 (0.77, 0.87) | 0.76 (0.70, 0.84) | |
| Table 1b. Association between Place of Birth and Clinical Outcomes* | |||||
| Death | US born | 93/238 | 3.95 | Ref | Ref |
| Not-US born | 169/474 | 3.65 | 0.91 (0.71, 1.17) | 0.70 (0.51, 0.96) | |
| ESKD | US born | 74/238 | 3.88 | Ref | Ref |
| Not-US born | 220/474 | 7.38 | 1.87 (1.43, 2.43) | 1.01 (0.72, 1.40) | |
| CV Event | US born | 77/238 | 4.43 | Ref | Ref |
| Not-US born | 128/474 | 3.89 | 0.84 (0.64, 1.12) | 0.87 (0.61, 1.24) | |
| Hospitalization | US born | 1725/238 | 73.18 | Ref | Ref |
| Not-US born | 2661/474 | 57.50 | 0.79 (0.74, 0.83) | 0.81 (0.75, 0.88) | |
Adjusted for center, age, sex, education, diabetes, hypertension, cardiovascular disease at baseline, smoking, body mass index, eGFR, and UPCR, *Rate ratio
Funding
- NIDDK Support