Virginia Research Day 2025

Medical Student Research Clinical

14 Impact of Food Desert Residence on AKI Risk Among Hospitalized Stage 3 CKD Patients with Metabolic Syndrome

Rebecca L. Wolf; Iva Skobic; Benjamin Pope; Hassan Chamas; Nishtha Sharma; Kayla Larsen; Angela Zhu; Hal Bright; Patricia Haynes Corresponding author: pyanambakkam@vcom.edu

Edward Via College of Osteopathic Medicine - Virginia Campus LewisGale Montgomery Hospital, Blacksburg, Virginia

Chronic kidney disease (CKD) affects approximately 37 million people in the United States, with Stage 3 CKD patients at heightened risk for progression to acute kidney injury (AKI), particularly with comorbidities such as metabolic syndrome. Living in a food desert, a geographic area with limited access to affordable, nutritious food, may increase this risk due to dietary limitations that impact metabolic health. However, the relationship between food access and AKI progression among hospitalized CKD patients has not been extensively studied. This study aims to assess whether residing in a food desert influences AKI risk among hospitalized Stage 3 CKD patients. We hypothesize that living in a food desert will increase the risk of AKI progression, particularly in those with metabolic syndrome. This retrospective cohort study utilizes data from hospitalized patients across HCA Healthcare hospitals diagnosed with Stage 3 CKD and will be grouped by residence in a food desert as defined by the U.S. Department of Agriculture (USDA) Food Access Research Atlas criteria from 2019, specifically low

income, low-access (LILA) areas. The USDA defines LILA areas as census tracts that are low-income and have limited access to supermarkets or grocery stores. Patients' food desert status will be determined by residential address, matched with the USDA Atlas data. Concurrent metabolic syndrome diagnosis will be identified using ICD-10 coding for conditions associated with metabolic syndrome, including hypertension, dyslipidemia, obesity, insulin resistance, as well as BMI values. AKI progression will be measured using ICD-10 codes for acute kidney injury during hospitalization. Given that dietary factors influence CKD progression and metabolic health, limited healthy food access may be an underrecognized risk factor for AKI, especially in those with metabolic syndrome. Food insecurity can lead to unhealthy dietary choices, often high in sodium and low in potassium. These foods can worsen CKD progression, metabolic syndrome, and hypertension, which can increase susceptibility to AKI. Identifying food deserts as a risk factor for AKI

progression in hospitalized CKD patients may guide future interventions targeting dietary support and food access in vulnerable populations, potentially reducing in-hospital complications and improving patient outcomes. Results from this study will provide insight into the role of food quality on kidney health and may inform healthcare providers and policymakers about the broader socioeconomic determinants of AKI in CKD patients. This study highlights a crucial opportunity to address social determinants of health in CKD management by improving food access. Hospital based interventions, such as screening for food insecurity upon admission, can help identify high risk patients who may benefit from tailored dietary counseling. Connecting CKD patients with resources like meal delivery services, nutritional counseling, or local food banks may reduce AKI progression post-discharge. Expanding access to nutritious foods and integrating food support into CKD management could become vital components of AKI prevention in vulnerable populations.

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