ArticleBMC nephrology2021
The relationship between financial hardship and incident diabetic kidney disease in older US adults - a longitudinal study.
Article in BMC nephrology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 12 citations in OpenAlex.
- Financial Toxicity in Diabetes: The State of What We Know.Current diabetes reports · 2025Pooled it
- Financial strain measures and associations with adult health: A systematic literature review.Social science & medicine (1982) · 2025Pooled it
- Development and internal validation of an interpretable machine-learning model for identifying comorbid atrial fibrillation in patients with diabetic kidney disease.Frontiers in clinical diabetes and healthcare · 2026Article
- Socioeconomic Status, Modifiable Factors, and Risk of Microvascular Complications in Individuals With Type 2 Diabetes: A Cohort Study From the UK Biobank.Journal of diabetes · 2025Article
- Financial Toxicity and Kidney Disease in Children and Adults: A Scoping Review.International journal of nephrology and renovascular disease · 2025Review
- Role of vitamin D in the development and progression of diabetic kidney disease: an overview of meta-analyses.Therapeutic advances in endocrinology and metabolism · 2025Review
- Social prescribing for socially isolated older adults in rural Japan: a qualitative case study.Frontiers in public health · 2025Article
- Financial Toxicity in Renal Patients (FINTORE) Study: A Cross-Sectional Italian Study on Financial Burden in Kidney Disease-A Project Protocol.Methods and protocols · 2024Article
- Association of Food Insecurity With Allostatic Load Among Older Adults in the US.JAMA network open · 2021Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundFinancial hardship is associated with poor health, however the association of financial hardship and incident diabetic kidney disease (DKD) is unknown. This study aimed to examine the longitudinal relationship between financial hardship and incident DKD among older adults with diabetes.
methodsAnalyses were conducted in 2735 adults age 50 or older with diabetes and no DKD using four waves of data (2006-2012) from the Health and Retirement Study, a national longitudinal cohort. The primary outcome was incident DKD. Financial hardship was based on three measures: 1) difficulty paying bills; 2) food insecurity; and 3) cost-related medication non-adherence using validated surveys. A dichotomous financial hardship variable (0 vs 1 or more) was constructed based on all three measures. Cox regression models were used to estimate the association between financial hardship, change in financial hardship experience and incident DKD adjusting for demographics, socioeconomic status, and comorbidities.
resultsDuring the median follow-up period of 4.1 years, incident DKD rate was higher in individuals with versus without financial hardship (41.2 versus 27/1000 person years). After adjustment, individuals with financial hardship (HR 1.32, 95% CI 1.04-1.68) had significantly increased likelihood of developing DKD compared to individuals without financial hardship. Persistent financial hardship (adjusted HR 1.52 95% CI 1.06-2.18) and negative financial hardship (adjusted HR 1.54 95% CI 1.02-2.33) were associated with incident DKD compared with no financial hardship experience. However, positive financial hardship was not statistically significant in unadjusted and adjusted (adjusted HR 0.89 95% CI 0.55-1.46) models. Cost-related medication non-adherence (adjusted HR 1.43 95% CI 1.07-1.93) was associated with incident DKD independent of other financial hardship measures.
conclusionsFinancial hardship experience is associated with a higher likelihood of incident DKD in older adults with diabetes. Future studies investigating factors that explain the relationship between financial hardship and incident DKD are needed.
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