Younger adults on hemodialysis at risk for food insecurity-linked hospitalization
Key takeaways:
- Hospitalization risk was higher for patients younger than 55 years who experienced food insecurity.
- Researchers observed a link between food insecurity and hospitalizations for fluid or electrolyte issues.
Younger adults on in-center hemodialysis may face higher risk for food insecurity-linked hospitalization than their older counterparts, researchers found.
“Food insecurity is common among people receiving in-center hemodialysis, and it increases risk of electrolyte- or fluid-related hospitalizations,” Kathryn S. Taylor, PhD, MPH, RN, assistant professor of medicine at Johns Hopkins University School of Nursing, told Healio. “This may be because people experiencing food insecurity miss hemodialysis treatments more often. Also, food insecurity may increase all-cause hospitalization risk more in younger people than older people in this population.”
Researchers enrolled 288 patients, aged 18 years or older, at 17 dialysis facilities in Maryland, Washington, D.C., and Virginia from February to December 2021. Participants in the prospective study lived in residentially segregated communities and were on chronic in-center hemodialysis for at least 3 months.
Participants completed a baseline food insecurity survey. Researchers then followed the cohort for 6 months through their dialysis facility electronic medical record. The analysis censored patients based on dialysis modality change, transplant, facility transfer, follow-up loss, death or the end of the study.
Overall, 22% of patients reported food insecurity within the past year. Moreover, 32% of patients had at least one hospitalization, Taylor and colleagues found.
Food insecurity was not a major predictor of all-cause hospitalization, as seen in the adjusted hazard ratio (aHR = 1.06; 95% CI, 0.63-1.8). However, the risk for hospitalization was higher for patients with food insecurity younger than 55 years (aHR = 2; 95% CI, 0.91-4.42) compared with patients aged at least 55 years (aHR = 0.63; 95% CI, 0.28-1.41).
The researchers also found a link between food insecurity and fluid- or electrolyte- hospitalizations: Affected patients had a threefold higher risk (aHR = 3.04, 95% CI, 1.16-7.96).
“We need to ask people about their context — outside of the dialysis facility, outside of their lives as ‘dialysis patients’ — especially if people are missing treatments or hospitalized frequently,” Taylor said. “We need to ask about their access to healthy foods instead of simply reeducating them. ... We urgently need research to test interventions to address food insecurity and other health-related social needs. Some of this work has already started, but this body of research is still in very early stages."
For more information:
Kathryn S. Taylor, PhD, MPH, RN, can be reached at ktaylo45@jhmi.edu.
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