68 - Neighborhood Socioeconomic Characteristics in Children with FSGS
Sunday, April 24, 2022
3:30 PM – 6:00 PM US MT
Poster Number: 68
Miahje Williams, Johns Hopkins University School of Medicine, Washington, DC, United States; Sara A. Boynton, Johns Hopkins University School of Medicine, Baltimore, MD, United States; Meredith Atkinson, Johns Hopkins University School of Medicine, Baltimore, MD, United States
Summer Scholar Student Johns Hopkins University School of Medicine Washington, District of Columbia, United States
Background: Neighborhood characteristics, in additional to individual socioeconomic (SE) factors, have been associated with health outcomes in children, but this has not been well described in children with chronic kidney disease (CKD) secondary to focal segmental glomerulosclerosis (FSGS).
Objective: To describe neighborhood and individual SE characteristics, in addition to demographic and clinical characteristics, in children with CKD secondary to FSGS enrolled in the multi-center Chronic Kidney Disease in Children (CKiD) cohort study, and to compare with characteristics in children with other causes of CKD.
Design/Methods: We conducted a retrospective cohort study in CKiD. Measures of neighborhood SE status were taken from the US Census and matched to participants with FSGS at the census block group (CBG) level, as coded by site coordinators using the census.gov website. CBG data was collected starting in 2009, and 578 CKiD participants had available data and were included in this analysis. Individual SE characteristics were obtained by parent/caregiver self-report. Wilcoxon rank-sum testing was used to compare characteristics between children with FSGS vs. other causes of CKD.
Results: 57 children with FSGS had individual and neighborhood SE data available. Demographic, clinical, and SE characteristics for children with FSGS compared to those with other underlying causes of CKD are presented in Table 1. Children with FSGS were older and more likely to be Black than those with other causes of CKD, but there was no difference in gender or baseline eGFR. There was no difference between groups in proportion of families reporting income > $36K/year, but those with FSGS lived in neighborhoods with lower median neighborhood income, and were less likely to have parents living together or to have a mother with some college. Despite no difference in baseline eGFR, more children with FSGS (43.9%) required renal replacement therapy (RRT) during follow up compared to those with non-FSGS CKiD. The modality of first RRT differed by group, with 84% of those with FSGS having dialysis as first RRT (vs. preemptive renal transplant) vs. 59.8% of those with non-FSGS CKD.Conclusion(s): Children with FSGS resided in lower-income neighborhoods than those with other causes of CKD, despite no significant difference in either neighborhood density or proportion with family-reported household income < $36K/year. Given that children with FSGS in the CKiD cohort demonstrate more progression to RRT, further study is needed to examine whether neighborhood-level factors are independently associated with risk for CKD progression. Table 1