Division of Nephrology, Department of Internal Medicine, Dell Medical School, University of Texas at Austin, Austin, Texas.
Johns Hopkins Center for Health Equity and.
Kidney360. 2020 Mar 31;1(4):241-247. doi: 10.34067/KID.0000032019. eCollection 2020 Apr 30.
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.
We used longitudinal data from the Healthy Aging in Neighborhoods of Diversity across the Life Span study (Baltimore, MD). We used multivariable regression to quantify associations between housing insecurity and rapid kidney function decline (loss of >5 ml/min per 1.73 m of eGFR per year) and, among those without kidney disease at baseline, incident reduced kidney function (eGFR <60 ml/min per 1.73 m) and incident albuminuria (urine albumin-creatinine ratio [ACR] ≥30 mg/g).
Among 1262 participants, mean age was 52 years, 40% were male and 57% were black. A total of 405 (32%) reported housing insecurity. After a median of 3.5 years of follow-up, rapid kidney function decline, incident reduced kidney function, and incident albuminuria occurred in 199 (16%), 64 (5%), and 74 (7%) participants, respectively. Housing insecurity was associated with increased odds of incident albuminuria (unadjusted OR, 2.04; 95% CI, 1.29 to 3.29; adjusted OR, 3.23; 95% CI, 1.90 to 5.50) but not rapid kidney function decline or incident reduced kidney function.
In this urban population, housing insecurity was associated with increased risk of subsequent albuminuria. Increased recognition of housing insecurity as a social determinant of kidney disease is needed, and risk-reduction efforts that specifically target populations experiencing housing insecurity should be considered.
住房无保障的特征是住房成本高或居住条件不安全，这会妨碍自我护理并威胁独立性。我们研究了住房无保障与肾脏疾病风险之间的关系。
我们使用了多样性在整个生命跨度中的邻里健康研究（巴尔的摩，MD）的纵向数据。我们使用多变量回归来量化住房无保障与肾功能快速下降（每年 eGFR 每 1.73m 损失>5ml/min）之间的关联，以及在基线时没有肾脏疾病的人群中，肾功能下降（eGFR<60ml/min/1.73m）和白蛋白尿（尿白蛋白-肌酐比[ACR]≥30mg/g）的发生率。
在 1262 名参与者中，平均年龄为 52 岁，40%为男性，57%为黑人。共有 405 名（32%）报告住房无保障。在中位随访 3.5 年后，199 名（16%）、64 名（5%）和 74 名（7%）参与者分别发生肾功能快速下降、新发肾功能下降和新发白蛋白尿。住房无保障与新发白蛋白尿的发生几率增加相关（未调整的 OR，2.04；95%CI，1.29 至 3.29；调整后的 OR，3.23；95%CI，1.90 至 5.50），但与肾功能快速下降或新发肾功能下降无关。
在这个城市人群中，住房无保障与随后发生白蛋白尿的风险增加相关。需要更加认识到住房无保障是肾脏疾病的社会决定因素，应该考虑针对住房无保障人群的风险降低措施。
