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Homelessness and Risk of End-stage Renal Disease JOURNAL OF HEALTH CARE FOR THE POOR AND UNDERSERVED Maziarz, M., Chertow, G. M., Himmeffarb, J., Hall, Y. N. 2014; 25 (3): 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 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.

View details for Web of Science ID 000340306300021

View details for PubMedID 25130236

View details for PubMedCentralID PMC4285149