Disparities in CKD Risks: Data from the CURE-CKD COVID-19 Sub-Registry

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Background: The SARS-CoV-2 pandemic accelerated health disparities in chronic kidney disease (CKD). Here, we describe risk factors and access to care surrogates (area deprivation index-ADI) for clinical outcomes among SARS-CoV-2-tested patients in the CURE-CKD Registry. Methods: We formed a COVID-19 Sub-Registry within CURE-CKD (1/1-6/30/2021; N=171,988) of patients with CKD, diabetes (DM)/pre-DM, or hypertension (HTN) with SARS-CoV-2 testing at UCLA Health (UCLA; N=17,884) and Providence St. Joseph Health (PSJH; N=154,104). Statistical analyses and fitted multivariable logistic regression models were adjusted for age and sex. The UCLA cohort included analyses for acute kidney injury (AKI), ADI (for poor housing, education, income), Charlson Comorbidity Index (CCI), and severe COVID-19 disease. Results: Odds ratios (OR) of COVID-19 positivity for the combined UCLA + PSJH population, as well as OR of having severe COVID-19 disease in the UCLA cohort are presented (Table). OR[95%CI] for AKI were higher for ages ≥80 years (1.77[1.14-2.46]), ADI by state (1.12[1.06-1.18]), CKD (12.20[8.46-17.58]) and pre-existing DM (3.65[2.62-5.08]), p<0.001. In the UCLA CURE-CKD population, AKI was associated with severe COVID-19 (r=0.26) and ICU admissions (r=0.29). Mortality was associated with severe COVID-19 disease (r=0.5). Conclusions: Non-White and/or LatinX race/ethnicity, ADI, CKD, DM, and older age were associated with higher risks of COVID-19 positivity, disease severity, and mortality in CURE-CKD. Efforts on viral screening, timely COVID-19 diagnosis, and optimal care delivery for patients with or at-risk for CKD are needed. Funding: Private Foundation SupportTable:: Results from the CURE-CKD COVID-19 Sub-Registry

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