Abstract: FR-PO1025
Social Risk Factors Associated with Disparate Posthospitalization Care among AKI Survivors
Session Information
- Social, Environmental, and Economic Determinants of Kidney Health
October 25, 2024 | Location: Exhibit Hall, 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
- Takeuchi, Tomonori, The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Babroudi, Seda, Tufts Medical Center, Boston, Massachusetts, United States
- Ghazi, Lama, The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Gutierrez, Orlando M., The University of Alabama at Birmingham, Birmingham, Alabama, United States
- Neyra, Javier A., The University of Alabama at Birmingham, Birmingham, Alabama, United States
Background
The 2012 Kidney Disease Improving Global Outcomes (KDIGO) acute kidney injury (AKI) practice guideline recommends kidney function to be reassessed within 3 months of AKI occurrence. The purpose of this study was to evaluate the association of social risk factors with receipt of post-hospitalization AKI care within 3 months among KDIGO stage 2 and 3 AKI survivors of intensive care unit (ICU) hospitalization.
Methods
Using data from a single academic center in the Southwestern United States, we retrospectively evaluated the association of insurance status, Area Deprivation Index (ADI), and Rural Urban Commuting Area (RUCA) code with receipt of post-AKI care. Patients aged ≥18 years hospitalized in the ICU with KDIGO stage 2 or 3 AKI between 10/2014 and 9/2017 who survived 90 days post-hospital discharge and did not require dialysis were included. Receipt of post-AKI care was defined as occurrence of a clinic visit and serum creatinine measurement within 90 days of hospital discharge. Multivariable logistic regression was performed, adjusting for patient demographics, comorbidities, and AKI severity.
Results
Of 1491 critically-ill AKI survivors, mean (SD) age was 55.8 (17.1), 40.2% were Black, 9.7% were uninsured, 30.2% lived in a neighborhood with the highest disadvantage, and 6.8% lived in a rural neighborhood. Only 536 (35.9%) patients received post-AKI care within 3 months. Uninsured status (aOR 0.44 [95% CI, 0.27, 0.68]) and living in a neighborhood of socioeconomic deprivation (highest tertile of ADI, aOR 0.72 [95% CI, 0.58, 0.89]) were significantly associated with decreased odds of receiving post-AKI care after adjustment (Table 1).
Conclusion
Only one-third of critically-ill KDIGO stage 2 or 3 AKI survivors had an outpatient visit and a serum creatinine measurement within 3 months of hospital discharge. Uninsured status and high neighborhood area deprivation significantly and negatively associated with follow-up, suggesting presence of socioeconomic disparities in post-AKI care.
Funding
- Other NIH Support