Abstract: SA-PO0962
Language Barrier and Long-Term Risk of AKI and CKD in Patients with Hypertension and Diabetes: Global Cohort Study Using Real-World Data
Session Information
- Diversity and Equity in Kidney Health
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Kaur, Gurwant, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
- Siddiqi, Mahwash, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
- Tahir, Maria, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
- Raza, Muhammad, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
- Ghahramani, Nasrollah, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, United States
Group or Team Name
- Penn State Nephrology
Background
Social determinants of health (SDOH) play a significant role in care of patients with chronic medical conditions. We aimed to assess the incidence of acute kidney injury (AKI), chronic kidney disease (CKD), dialysis and transplant among patients with diabetes mellitus (DM) and hypertension (HTN) with or without language barrier (ICD-10: Z55.5).
Methods
Using the TriNetX Research Network (105 healthcare organizations), we identified patients aged 18–99 years with documented history of DM and HTN. Cohorts were matched for demographics. Cohort 1 (n = 302 before matching, 264 after matching) included patients with DM and HTN with language barrier (ICD: Z55.5). Cohort 2 (n = 448,267 before matching, 264 after matching) included patients with DM and HTN without language barrier. Outcomes were evaluated from one day post-index event through the available follow-up period. Mean follow up time was 321 days for cohort 1 and 1830 days for cohort 2. The primary outcome was incidence of AKI and CKD (ICD-10: N17 and N18 respectively). Secondary outcomes included need for dialysis and kidney transplants. Kaplan-Meier survival curves, survival probability (SP), hazard ratios (HR), and risk ratios (RR) were calculated.
Results
Patients with DM and HTN with history of language barrier (cohort 1) had significantly increased risk of AKI 42.8% vs. 34.8% (RR 1.22; p 0.0608; SP 27.08% vs. 23.71; HR 4.35), CKD: 52.27% vs. 45.83% (RR 1.14; SP 39.56% vs. 19.16%; HR 2.64) and dialysis: 13.25% vs. 4.92% (RR 2.692; SP 60.12% vs. 93.28%; HR 5.62) as compared to the control group (cohort 2). Sample size was too small for analyses for transplant status among the cohorts.
Conclusion
In this large, multicenter real-world cohort, history of language barrier was strongly associated with increased risk of AKI, CKD and dialysis. These findings underscore the need for long-term and equitable nephrology follow-up and risk-based screening protocols for such patients.