Addressing Housing Issues Among People With Kidney Disease: Importance, Challenges, and Recommendations.

Kidney disease disproportionately impacts people with low socioeconomic status, and low socioeconomic status is associated with worse outcomes for people with kidney disease. Unstable housing, which includes housing insecurity and homelessness, is increasing due to rising housing costs. There is mounting evidence that unstable housing and other health-related social needs are partially driving worse outcomes for people with low socioeconomic status.

Social and Behavioral Barriers to Effective Care During the Transition to End-Stage Kidney Care.

Individuals living with CKD are disproportionately burdened by a multitude of adverse clinical and person-centered outcomes. When patients transition from advanced kidney disease to kidney failure, the psychosocial effects as well as social determinants of health challenges are magnified, making this a particularly difficult time for patients beginning kidney replacement therapy. The key social determinants of health challenges often include food and housing insecurity, poverty, unreliable transportation, low level education and/or health literacy, lack of language interpreters and culturally concordant educational materials, lack of health care insurance coverage, and mistrust of the health care system.

Patients' Perspectives on Health-Related Social Needs and Recommendations for Interventions: A Qualitative Study.

Rationale & Objective: People with low socioeconomic status are disproportionately affected by kidney failure, and their adverse outcomes may stem from unmet health-related social needs. This study explored hemodialysis patient perspectives on health-related social needs and recommendations for intervention.

Study Design: Qualitative study using semistructured interviews.

Unstable Housing and Mortality Among US Veterans Receiving Dialysis.

Importance: Housing status is an important health determinant, yet little is known about unstable housing among individuals receiving dialysis.

Objective: To determine factors associated with unstable housing among US veterans receiving dialysis and to estimate the association of unstable housing with risk of death.

Design, Setting, And Participants: This retrospective cohort study used data from the US Veterans Health Administration (VHA) and the US Renal Data System for patients who initiated dialysis between October 1, 2012, and December 31, 2018.

Material Need Insecurities among People on Hemodialysis: Burden, Sociodemographic Risk Factors, and Associations with Substance Use.

Key Points: Food insecurity and housing instability may affect dialysis outcomes through health behaviors like treatment adherence and their effect on access to transplantation or home dialysis therapies. People on hemodialysis who were younger, with less educational attainment, with lower incomes, or experiencing financial strain were more likely to experience material need insecurities. Participant race was not associated with material need insecurities, although residential segregation moderated associations between age, sex, and food insecurity.

Proceedings of a Workshop to Promote Community Health Worker Interventions in Nephrology.

Latinx populations face a higher burden of kidney failure and associated negative outcomes compared with non-Latinx White populations, despite sharing a similar prevalence of CKD. Community health worker (CHW) interventions have been shown to improve outcomes for Latinx individuals, but they are largely underutilized in kidney disease. We convened a workshop of four ongoing kidney disease CHW programs to identify successes, challenges, potential solutions, and needed research to promote CHW programs for Latinx individuals with kidney disease.

Facilitating Medical Care for Latinx Individuals at Risk for CKD: A Pilot Intervention.

Rationale And Objective: Latinx individuals are at a higher risk for kidney failure than non-Latinx White individuals; however, they are less likely to receive pre-kidney failure medical care. The objective of this study was to determine the feasibility and acceptability of a community health worker (CHW) intervention that facilitated access to medical care for Latinx individuals.

Study Design: Single-arm prospective study.

Coping Behaviors and Incident Kidney Disease.

Key Points: Adaptive coping behaviors are associated with lower odds of incident CKD. Coping behaviors could represent a target to prevent CKD.

Background: How someone copes may alter the trajectory of their kidney function.

Unstable Housing and Kidney Disease: A Primer.

Stable housing is essential for health. Over 580,000 Americans experienced homelessness during one night in 2020, and over 37 million households spend over 30% of their income on housing. Unstable housing has been associated with mortality, acute care utilization, communicable and non-communicable diseases, a higher risk of kidney disease, and kidney disease progression.

Disparities in Mental Health and Well-Being Among Black and Latinx Patients With Kidney Disease.

Black and Latinx individuals in the United States are afflicted disproportionately with kidney disease. Because of structural racism, social risk factors drive disparities in disease prevalence and result in worse outcomes among these patient groups. The impact of social and economic oppression is pervasive in physical and emotional aspects of health.

Perspectives on Kidney Disease Education and Recommendations for Improvement Among Latinx Patients Receiving Emergency-Only Hemodialysis.

Importance: In most states, undocumented Latinx immigrants with kidney failure receive dialysis in acute care settings on an emergency-only basis. How much kidney disease education Latinx immigrants receive and how to improve kidney disease education and outreach among Latinx populations are unknown.

Objective: To understand the kidney disease educational gaps of Latinx individuals who need but lack access to scheduled outpatient dialysis.

Gender Disparities in Authorship of Invited Manuscripts During the COVID-19 Pandemic.

Women have historically been under-represented in medical literature, particularly prominent in authorship of invited commentaries. With the instantaneous change in work environment forcing Americans to adapt to working at home, many theorize that women will be more adversely affected due to traditional concepts of women being more responsible for the home in addition to work responsibilities. Understand how women contributed to coronavirus disease 2019 (COVID-19) literature early in the pandemic.

COVID-19 and Kidney Disease Disparities in the United States.

Racial, ethnic, socioeconomic, age, and sex-related health disparities in kidney disease are prominent in the United States. The Coronavirus Disease 2019 (COVID-19) pandemic has disproportionately affected marginalized populations. Older adults, people experiencing unstable housing, racial and ethnic minorities, and immigrants are potentially at increased risk for infection and severe complications from COVID-19.

The impact of donor urine chemical toxicology analysis on outcomes of kidney transplantation.

Background: Acceptance of organs from acute chemical intoxicated donors remains controversial and outcomes are insufficiently explored.

Methods: This is a single-center retrospective cohort analysis of 484 patients undergoing deceased donor kidney transplantation (DDKT). We assessed the association of positive urine drug screen before transplantation with cohort statistics, delayed graft function (DGF), and graft outcomes at 2 years.

Housing Insecurity and Risk of Adverse Kidney Outcomes.

Background: Housing insecurity is characterized by high housing costs or unsafe living conditions that prevent self-care and threaten independence. We examined the relationship of housing insecurity and risk of kidney disease.

Methods: We used longitudinal data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Baltimore, MD).

Achieving equity in dialysis care and outcomes: The role of policies.

Socially disadvantaged persons, including racial and ethnic minorities, individuals with low incomes, homeless persons, and non-US citizens bear a disproportionate burden of end-stage kidney disease (ESKD). Inequities in nephrology referral, vascular access, use of home dialysis modalities, kidney transplantation, and mortality are prominent. Public policies, including the Patient Protection and Affordable Care Act, end-stage renal disease Quality Incentive Program, and the Prospective Payment System, were enacted to improve healthcare access and dialysis care.