Homeless with Kidney Disease

Kidney disease patients who are homeless may face higher risks

(RxWiki News) Homeless people lack more than a roof over their heads; they also lack access to many of the basic healthcare services many of us take for granted.

Homeless people with kidney disease may have a higher risk of kidney failure and early death compared to others with moderate to advanced chronic kidney disease.

In addition, homeless kidney disease patients use emergency services more than poor people with stable housing.

"Get regular care for kidney disease."

These findings - made by Yoshio Hall, MD, of the University of Washington, and colleagues - suggest that more effort is needed to improve the health of homeless people with kidney disease and to lower the related public health costs.

From their study, Dr. Hall and colleagues found that homeless kidney patients were 82 percent more likely to develop kidney failure or die, compared to poor adult patients with stable housing.

After the researchers accounted for other kidney risk factors (i.e., demographics, drug abuse and other health problems), homeless kidney patients still had a 28 percent increased risk of kidney failure or death.

Between 1996 and 2005, about half of homeless kidney patients visited the emergency room more than nine times, and were hospitalized more than five times. In comparison, patients with stable housing had no more than one emergency room visit or hospitalization.

Compared to poor kidney patients with stable housing, homeless kidney patients were younger and more likely to be male and uninsured. Homeless patients also were more likely to be depressed and to abuse substances.

According to Dr. Hall, it is an unfortunate reality that homeless people's hunt for shelter, food and clothing often competes with regular health care, which can lead to a higher use of more expensive services for chronic conditions like kidney disease.

Homeless people might use these costly services less if they have better access to transportation, social work services, better nutrition and doctors, said Dr. Hall.

More research is needed to see if access to these support services actually improves the health of homeless patients and reduces public healthcare costs.

For their study, the researchers looked at the medical records of more than 15,000 adults with moderate to advanced chronic kidney disease.

Dr. Hall has received support from Satellite Healthcare's Norman Coplon extramural grant program.

Study co-author Glenn Chertow, MD, is a member of the Board of Directors of Satellite Healthcare and the Scientific Advisory Board of DaVita, Inc. He has also consulted for Amgen, Inc.

The research is published in the Clinical Journal of the American Society of Nephrology.

Review Date: 
July 22, 2012