Kidney Week

Abstract: SA-OR028

CKD Awareness and Sex Differences in a High-Risk Population in the US Deep South

Session Information

• CKD in Overlooked Populations
  October 24, 2026 | Location: Mile High Ballroom 1A, Convention Center
  Abstract Time: 04:30 PM - 04:40 PM

Category: CKD (Non-Dialysis)

• 2201 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Alvarado, Flor, Tulane University, New Orleans, Louisiana, United States

Flor Alvarado, MD, MPH

• O'Connell, Samantha S., Tulane University, New Orleans, Louisiana, United States

Samantha S. O'Connell, MS, PhD

• Durst, Lucia, Tulane University, New Orleans, Louisiana, United States

Lucia Durst

• Mills, Katherine T., Tulane University, New Orleans, Louisiana, United States

Katherine T. Mills

Background

Chronic kidney disease (CKD) awareness remains low, even among high-risk populations. We assessed CKD prevalence, patient-level unawareness, and factors associated with unawareness among hypertensive patients in the Deep South, with particular attention to sex differences.

Methods

We conducted a cross-sectional analysis of participants from the IMPACTS-MIND trial, a cluster-randomized study targeting systolic blood pressure <120 mmHg. The trial enrolled predominantly racial minority patients with hypertension from 11 federally qualified health centers in Louisiana and Mississippi. CKD was defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² based on laboratory assessment. CKD unawareness was defined as absence of self-reported CKD among individuals with laboratory-confirmed CKD. Associations between participant characteristics (sex, age, race, education, diabetes, hyperlipidemia, heart failure, and prior myocardial infarction) and CKD unawareness were examined using Poisson regression with robust standard errors to estimate prevalence ratios (PRs), accounting for clustering by clinic. Effect modification by sex was evaluated using stratified models.

Results

Among 177 participants, 44 (25%) had laboratory-confirmed CKD; however, only 7 (4% overall) reported awareness. Among those with CKD, the mean age was 71 years, 64% were Black, and 32% had a high school education or less. CKD awareness did not differ by sex (PR 0.99, 95% CI 0.80–1.23). Hyperlipidemia was associated with lower CKD unawareness (PR 0.82, 95% CI 0.68–0.99). In contrast, heart failure (PR 1.17, 95% CI 1.01–1.36) and prior myocardial infarction (PR 1.17, 95% CI 1.01–1.35) were associated with greater CKD unawareness. Age, race, education, and diabetes were not significantly associated with CKD awareness. Sex-stratified analyses did not demonstrate consistent effect modification.

Conclusion

CKD unawareness is markedly high among hypertensive patients receiving care in federally qualified health centers in the Deep South. Notably, individuals with cardiovascular comorbidities remain disproportionately unaware despite elevated risk. Targeted interventions are needed to improve CKD recognition and reduce disparities in high-risk, underserved populations.

Funding

• Other NIH Support