| Older adults |
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Higher risk of COVID-19 infection and complications which may exacerbate kidney disease and other conditions
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Potential worsening of frailty and depression due to shelter-in-place which increase risk for hospitalization, mortality, and allograft loss
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Potential inability to access telehealth due to cognition, vision/hearing impairment, and lack of required technology may lead to limited access to nephrology care
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Increase testing and isolation of positive cases in retirement communities
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Research is needed to identify effective nephrology telehealth interventions catered to the unique needs of older adults
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Research is needed to determine the impact of shelter-in-place on frailty, depression, and long-term outcomes among older adults with kidney disease
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| People experiencing unstable housing |
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Higher prevalence of chronic medical conditions and mortality compared to general population
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Homeless adults with CKD have higher risk of ESKD and acute care utilization than stably housed counterparts
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Higher risk of COVID-19 which may exacerbate kidney disease and other chronic conditions
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Limited access to telehealth which may exacerbate chronic conditions and further increase reliance on acute care
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Increase testing and isolation of positive cases in shelters
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Investment in housing for symptomatic and positive cases
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Extend eviction moratorium
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Research is needed to determine how COVID-19 will impact health outcomes and mortality among those with unstable housing compared to stably housed populations with kidney disease
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Research is needed to determine how COVID-19 affects access to nephrology care
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Research is needed to identify effective nephrology telehealth interventions catered to the unique needs of people experiencing unstable housing
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| Sex and gender |
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Men have higher risk of progression of kidney failure and mortality from kidney failure
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Women with CKD are more likely to be a minority, to have low education, and low income
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Higher burden of caregiving on women
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Ensure that protective mechanisms for women and girl victims of violence remain accessible
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Advocacy for increased resources for community programs and policies that protect women
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Ensure access to sexual and reproductive health services
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Research is needed to determine etiology for disparate gender data
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| Racial and ethnic minorities |
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Minorities have higher incidence of renal failure and higher burden of untreated comorbidities than non-Latinx whites
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Minorities suffer health disparities stemming from structural racism including poverty, crowded living conditions, inadequate access to healthy foods, discrimination, uncertain legal status, poor access to care, and others
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Minorities are disproportionately affected by COVID-19 which may exacerbate kidney disease and other conditions
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Inability to social distance due to essential jobs and crowded living environments
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Limited access to telehealth due to language and technology barriers which may exacerbate disparities in access to nephrology care
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Improve data on socioeconomic status alongside data disaggregated by race and ethnicity in COVID-19 to guide efforts to allocate resources and reduce exposure
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Provide culture and language congruent outreach and communication by partnering with trusted community-based organizations and faith leaders
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Improve contact tracing
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Expand access to health care
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Prevention and treatment of comorbidities that increase morbidity and mortality such as metabolic conditions and cardiovascular disease.
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| People who are refugees, immigrants, and undocumented |
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Limited access to primary and nephrology care, increased reliance on acute care
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In most US states, ESKD patients rely on emergency-only dialysis, which is associated with higher morbidity and mortality
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Higher risk of COVID-19 exposure which may exacerbate kidney disease and other conditions
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Limited access to telehealth due to language and technology barriers which may exacerbate disparities in access to nephrology care
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Suspension of the Public Charge Rule
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Suspension of immigration enforcement
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Improve disaster relief assistance for immigrants who are ineligible for most forms of pandemic assistance
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Expand access to COVID-19 care by modifying the Emergency Medicaid definition
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Expand access to kidney replacement therapy by modifying the Emergency Medicaid definition
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Research is needed to determine how COVID-19 will affect outcomes among those receiving emergency-only dialysis
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Research is needed to determine how COVID-19 will impact access to nephrology care for this population
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Research is needed to identify effective nephrology telehealth interventions that are culturally responsive and language congruent
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