Insurance and neighborhood factors tied to kidney failure after ICU injury
Researchers followed 30,498 adults who had acute kidney injury in intensive care and survived to discharge, using records from 2012 to 2022. Black race was associated with a higher risk of later kidney failure, while health insurance coverage was linked to lower risk. Greater neighborhood socioeconomic disadvantage also independently predicted higher kidney failure risk.
The study tracked 30,498 adults who had acute kidney injury in intensive care and left the hospital alive, using 2012–2022 records from a large U.S. academic medical center. Follow-up lasted up to two years and combined hospital electronic health records with U.S. Renal Data System information.
During that period, 2,723 participants (9%) died and 326 (1%) developed kidney failure. After adjustment, Black patients had a 43% higher risk than white patients, insurance coverage was tied to a 40% lower risk, and living in more deprived neighborhoods was independently linked to greater risk, especially in moderately or highly deprived areas.
These findings could help clinicians and health systems identify ICU acute kidney injury survivors at greater risk after discharge, particularly Black patients, people without insurance, and residents of disadvantaged neighborhoods. More structured social-risk assessment may support earlier follow-up and tailored kidney monitoring, which could reduce avoidable complications for affected patients and families. Because the findings are associations, they cannot prove that insurance or neighborhood conditions cause kidney failure; societal impact may depend on how care teams use such information and whether support services are available.