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Homelessness and risk of end-stage renal disease

Maziarz, Marlena LU ; Chertow, Glenn M. ; Himmelfarb, Jonathan and Hall, Yoshio N. (2014) In Journal of Health Care for the Poor and Underserved 25(3). p.1231-1244
Abstract

To identify homeless people with chronic kidney disease (CKD) who were at highest risk for end-stage renal disease (ESRD), we studied 982 homeless and 15,674 domiciled people with CKD receiving public health care. We developed four risk prediction models for the primary outcome of ESRD. Overall, 71 homeless and 888 domiciled people progressed to ESRD during follow-up (median: 6.6 years). Homeless people with CKD experienced significantly higher incidence rates of ESRD than poor but domiciled peers. Most homeless people who developed progressive CKD were readily identifiable well before ESRD using a prediction model with five common variables. We estimated that program following homeless people in the highest decile of ESRD risk would... (More)

To identify homeless people with chronic kidney disease (CKD) who were at highest risk for end-stage renal disease (ESRD), we studied 982 homeless and 15,674 domiciled people with CKD receiving public health care. We developed four risk prediction models for the primary outcome of ESRD. Overall, 71 homeless and 888 domiciled people progressed to ESRD during follow-up (median: 6.6 years). Homeless people with CKD experienced significantly higher incidence rates of ESRD than poor but domiciled peers. Most homeless people who developed progressive CKD were readily identifiable well before ESRD using a prediction model with five common variables. We estimated that program following homeless people in the highest decile of ESRD risk would have captured 64-85% of those who eventually progressed to ESRD within five years. Thus, an approach targeting homeless people at high risk for ESRD appears feasible and could reduce substantial morbidity and costs incurred by this highly vulnerable group.

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author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Chronic kidney disease, End-stage renal disease, Homelessness, Risk prediction, Vulnerable populations
in
Journal of Health Care for the Poor and Underserved
volume
25
issue
3
pages
14 pages
publisher
Johns Hopkins University Press
external identifiers
  • pmid:25130236
  • scopus:84906055971
ISSN
1049-2089
DOI
10.1353/hpu.2014.0136
language
English
LU publication?
no
id
e14510ec-c7ab-446b-acbb-eb88fbc59052
date added to LUP
2019-08-05 13:15:29
date last changed
2020-04-02 02:39:23
@article{e14510ec-c7ab-446b-acbb-eb88fbc59052,
  abstract     = {<p>To identify homeless people with chronic kidney disease (CKD) who were at highest risk for end-stage renal disease (ESRD), we studied 982 homeless and 15,674 domiciled people with CKD receiving public health care. We developed four risk prediction models for the primary outcome of ESRD. Overall, 71 homeless and 888 domiciled people progressed to ESRD during follow-up (median: 6.6 years). Homeless people with CKD experienced significantly higher incidence rates of ESRD than poor but domiciled peers. Most homeless people who developed progressive CKD were readily identifiable well before ESRD using a prediction model with five common variables. We estimated that program following homeless people in the highest decile of ESRD risk would have captured 64-85% of those who eventually progressed to ESRD within five years. Thus, an approach targeting homeless people at high risk for ESRD appears feasible and could reduce substantial morbidity and costs incurred by this highly vulnerable group.</p>},
  author       = {Maziarz, Marlena and Chertow, Glenn M. and Himmelfarb, Jonathan and Hall, Yoshio N.},
  issn         = {1049-2089},
  language     = {eng},
  month        = {01},
  number       = {3},
  pages        = {1231--1244},
  publisher    = {Johns Hopkins University Press},
  series       = {Journal of Health Care for the Poor and Underserved},
  title        = {Homelessness and risk of end-stage renal disease},
  url          = {http://dx.doi.org/10.1353/hpu.2014.0136},
  doi          = {10.1353/hpu.2014.0136},
  volume       = {25},
  year         = {2014},
}