Social determinants of health influence risk, access to treatment of CKD
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ORLANDO — A patient’s social determinants of health will influence access to chronic kidney disease screening and diagnosis and treatment of CKD, researchers reported here.
“Clinical guidelines suggest regular chronic kidney disease (CKD) screening after diagnosis of hypertension (HTN) or type 2 diabetes (T2DM), as both are risk factors,” Marybeth Ingle, PhD, MPH, and colleagues wrote. “Monitoring of kidney function allows for early detection of CKD and can improve quality of life.”
However, routine care can be impacted by social determinants of health (SDOH), and SDOH can limit access to CKD screening. “We explore how SDOH factors from electronic health records (EHR) predict CKD screening and CKD development among newly diagnosed HTN and/or T2DM patients,” Ingle and colleagues wrote.
The researchers examined the EHRs of 235,208 patients with a new HTN and/or T2DM diagnosis between 2015 and 2018. Patients were followed for 3 years to assess whether they were able to obtain annual CKD screening and had CKD development (CKD or end-stage renal disease).
Most of the patients in the study were white (57%), female (55%) and had HTN (65%). “Screening was highest for patients who developed HTN and T2DM during the study (44%) compared to T2DM (38%) or HTN (4%),” the authors wrote. “CKD developed for 9% of patients. Public health insurance patients were 66% more likely to not be screened for CKD compared to patients with private insurance.”
Retired patients were less likely to not be screened; and Black patients, Hispanic patients and Asian American patients were less likely to not be screened compared with white patients. [Black patients] were over twice as likely to develop CKD,” the authors wrote.
“The increase in CKD incidence among Black and retired patients could be due to frequent screenings,” the authors concluded. “However, employment and single status were not a predictor of screening, yet a predictor of CKD.
“It’s possible lifestyle factors unique to this population contribute to CKD development,” they wrote.
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Ingle M, et al. Poster TH-PO718. Presented at: ASN Kidney Week; Nov. 3-6, 2022; Orlando (hybrid meeting).
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