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Related Concept Videos

Kidney Transplant I: Introduction01:28

Kidney Transplant I: Introduction

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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Chronic Kidney Disease I: Introduction01:25

Chronic Kidney Disease I: Introduction

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Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
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Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

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Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
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Chronic Kidney Disease II: Clinical Manifestations01:24

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Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
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Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

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Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
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Chronic Kidney Disease IV: Nursing Management01:18

Chronic Kidney Disease IV: Nursing Management

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Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
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Community-Based Screening for Unmet Social Needs and Kidney Disease Risk Factors: Findings from the DECK Pilot

Amber B Paulus1,2,3, April McGraw4, R K Elswick5

  • 1Associate Chief Nephrology Research and Data Analytics and an Assistant Professor, Department of Internal Medicine, Division of Nephrology School of Medicine, Virginia Commonwealth University, Richmond, VA.

Nephrology Nursing Journal : Journal of the American Nephrology Nurses' Association
|July 7, 2025
PubMed
Summary

Social determinants of health (SDOH) impact chronic kidney disease (CKD) risk. The DECK study found unmet social needs, especially financial and social, correlate with higher CKD risk in vulnerable populations.

Keywords:
access to carechronic kidney diseasecommunity-based researchpopulation healthpreventative screeningsocial determinants of health

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Area of Science:

  • Public Health
  • Nephrology
  • Health Equity

Background:

  • Social determinants of health (SDOH) are critical factors influencing chronic kidney disease (CKD) risk, especially in underserved communities.
  • Historically marginalized areas, like Richmond's East End, face significant social vulnerability impacting health outcomes.
  • Understanding the interplay between SDOH and CKD is essential for addressing health disparities.

Purpose of the Study:

  • To investigate the association between unmet social needs and CKD risk within a vulnerable population.
  • To assess CKD awareness and perceived preventability among residents in a historically underserved urban area.
  • To inform the development of targeted interventions for kidney health equity.

Main Methods:

  • The Designing Equitable Care for Kidneys (DECK) study enrolled 61 participants from Richmond, Virginia's East End.
  • Data collection included assessing CKD risk and identifying unmet social needs in financial and social domains.
  • Statistical analysis stratified the relationship between the severity of social needs and CKD risk levels.

Main Results:

  • CKD awareness was moderate (71%), with only 36% recognizing it as preventable.
  • Participants reported significant unmet needs, particularly in financial and social support.
  • A dose-response relationship was observed: moderate social needs were linked to the highest prevalence of moderate (24.6%) and high (9.8%) CKD risk.

Conclusions:

  • Unmet social needs, particularly financial and social, are significantly associated with increased chronic kidney disease risk.
  • Integrated interventions addressing both clinical and social determinants are necessary to mitigate kidney health disparities.
  • Targeting interventions in socially vulnerable populations is crucial for improving kidney health outcomes.