Food Assistance to Financially Insecure Children and Adolescents With Chronic Kidney Disease: Impact on Disease Progression.

OBJECTIVES

In North American children with chronic kidney disease (CKD), poverty correlates with faster disease progression. As an aspect of poverty, food insecurity is common among these children, yet its impact on CKD progression is underexplored. The purpose of this study was to assess the impact of food assistance (FA) on CKD progression by comparing the cumulative incidence and the hazard of kidney replacement therapy (KRT) initiation in those who reported receiving FA to those who did not.

DESIGN AND

METHODS

This study included longitudinal data collected over 10 years of follow-up from a subset of 266 participants from the Chronic Kidney Disease in Children prospective cohort study whose annual household income was ≤$36,000 to assess the association between FA and KRT initiation.

RESULTS

Over 388 person-years in which FA was reported, 21 KRT events occurred (KRT incidence rate of 5.4 per 100 person-years and estimated 10-year cumulative incidence of KRT of 41%), while during 592 person-years with no FA, 44 KRT events occurred (KRT incidence rate of 7.4 per 100 person-years and estimated 10-year cumulative incidence of KRT of 55%). FA recipients showed a trend toward a lower hazard of KRT initiation over 10 years of follow-up than those not receiving FA.

CONCLUSION

Our findings suggest that sustained FA participation may mitigate CKD progression. The study contributes to the growing body of evidence on the potential role of food security, including FA, in mitigating CKD outcomes among children.