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Kidney Week

Abstract: FR-PO726

Area Deprivation and Mineral Metabolism in Pediatric CKD

Session Information

  • Pediatric Nephrology - 1
    October 25, 2024 | Location: Exhibit Hall, Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

  • 1900 Pediatric Nephrology

Authors

  • Laster, Marciana, Indiana University School of Medicine, Indianapolis, Indiana, United States
  • Warady, Bradley A., University of Missouri-Kansas City School of Medicine, Kansas City, Missouri, United States
  • Furth, Susan L., The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
Background

CKD-MBD is a comorbidity of CKD that leads to poor growth, fractures and cardiovascular death. Levels of PTH and vitamin D differ by racial-ethnic group. Given that race is a social construct that coincides with a disproportionate burden of poverty within minorities, a complete understanding of racial differences must consider socioeconomic status (SES). The objective of this study is to define the relationship between SES and MBD markers including phosphate, calcium, intact parathyroid hormone (PTH), and 25-hydroxyvitamin D (25OHD).

Methods

In 540 participants from the CKID cohort, we assessed the relationship between area deprivation index (ADI), median household income (MHI) and longitudinal CKD-MBD biomarkers using linear mixed effects models with backward selection (p value <0.1). Biologically relevant variables including age, sex, and medication use were maintained in all models. Categories of deprivation (high vs. low) were defined according to previous standards as a value >=113.45.

Results

11.8% of participants lived in areas of high deprivation. Race differed between high and low deprivation cohorts (Table 1). In linear mixed effects models (Table 2), increasing deprivation was associated with lower 25OHD and increasing MHI with higher 25OHD. Stratification by Black and non-Black race demonstrated a persistent relationship but of greater magnitude in Black race. Of the other markers, only intact PTH demonstrated a trend with increasing MHI which predicted decreased PTH (Table 2).

Conclusion

Vitamin D status as reflected by 25OHD is related to area-level social metrics including ADI and median neighborhood income. Persistence upon racial stratification helps to untangle the structural contributors to vitamin D status. Further studies are needed to understand the specific contributors to this finding.

Funding

  • NIDDK Support