Table 2.

Studies evaluating the influence of housing in the setting of kidney disease.

Study	Design	Participants and Setting	Exposure	Primary Outcome	Relevant Results
Hall17	Cohort	15,343 adults with CKD stages 3-5 who received ambulatory care during 1996-2005 from the Community Health Network of San Francisco	Housing for which a person had adequate resources and there were no time limits	Kidney failure or death	Homelessness was associated with increased risk of kidney failure or death. In subgroup analysis, this relationship was only evident in people without a history of substance abuse.
Maziarz66	Cohort	16,656 adults with CKD stages 3-5 who received ambulatory care during 1996-2005 from the Community Health Network of San Francisco	Housing for which a person had adequate resources and there were no time limits	Time to kidney failure	Incidence of kidney failure was higher for homeless adults. A prediction model that incorporated age, sex, race/ethnicity, eGFR, and dipstick proteinuria identified homeless individuals at highest risk for progression.
Novick67	Cohort	25,689 U.S. veterans with kidney failure who initiated dialysis between 2012 and 2018, attended a Veterans Health Administration outpatient clinic and completed a housing screen within 3-years before starting dialysis	Self-report of not having stable housing within the past 2-months, or having concerns about stable housing in the next 2-months	All-cause mortality	Unstable housing was associated with higher risk of all-cause mortality, and risks increased with age. In age-stratified analyses, unstable housing was associated with higher mortality among Veterans aged 75-85 years, but not other age groups.
Novick14	Cohort	1,262 adults with normal kidney function in the Healthy Aging in Neighborhoods of Diversity across the Life Span study	Self-report of inability to afford a suitable home	Incident albuminuria, reduced kidney function, and rapid kidney function decline	Unstable housing was associated with increased odds of albuminuria but not reduced kidney function or rapid kidney function decline.
Novick15	Cross-sectional	1,753 adults with normal kidney function in the Healthy Aging in Neighborhoods of Diversity across the Life Span study	Self-report of health-related social needs, defined as unstable housing (inability to afford a suitable home) and/or food insecurity	Achieving ≥4 kidney protective measures (blood pressure ≤130/80 mmHg, hemoglobin A1c level ≤ 7.5%, average 2-day salt intake <2,000 mg/d, BMI ≤ 25 kg/m2, self-report of physical activity during leisure time, and current nonsmoker)	Health-related social needs were associated with lower odds of achieving ≥4 kidney protective measures.
Novick16	Cross-sectional	355 adults with CKD stages 3-5 in the Healthy Aging in Neighborhoods of Diversity across the Life Span study	Self-report of inability to afford a suitable home or difficulty making rent/mortgage payments	Self-report of postponing needed medical care	Unstable housing was associated with increased risk of postponing needed medical care.
Sung68	Single-center case series	144 patients with kidney failure and unstable housing undergoing vascular access creation	Absence of a permanent residence or ≥3 addresses the year before vascular access operation	90-day readmission and mortality	Absence of a permanent residence was associated with increased odds of 90-day readmission, but unstable housing was not associated with mortality.
Taylor69	Cross sectional	305 adults receiving hemodialysis	Self-report of not having stable housing within the past 2-months, or having concerns about stable housing in the next 2-months	Individual and area-level sociodemographic characteristics	Eighteen percent reported unstable housing. Annual income <$25,000 and <high school education were associated with unstable housing, and unstable housing was not associated with substance use.
Crews70	Single-arm pilot	12 older adults with low socioeconomic status receiving hemodialysis with identified functional needs and home environmental barriers to social engagement	Intervention included 5-months of home visits with an occupational therapist, nurse, and a handyman to provide ≤$1,300 worth of repairs or home modifications	Feasibility and acceptability of the intervention, and change in disability (ADLs and IADLs), social support, and social network scores	The pilot demonstrated feasibility and acceptability, and all participants exhibited improvements in disability, social support and social network scores.
Walker45	Qualitative	25 adults with kidney failure receiving home dialysis	Community house hemodialysis	Semi-structured interviews on perspectives of the community house hemodialysis model	Community house hemodialysis reduced costs of home hemodialysis, and enabled use when home was not an option.

Abbreviations: CKD – chronic kidney disease, ADLs – activities of daily living, IADLs – instrumental activities of daily living, eGFR – estimated glomerular filtration rate.