Abstract Body: Background: Older adults with chronic kidney disease (CKD) are at an increased risk of hospitalizations and death compared to younger adults. Social support is a potentially modifiable risk factor that has been understudied in this population. We evaluated the relationship between social support and the risk of hospitalization and mortality among older adults with mild to advanced CKD.

Methods: Data from the Chronic Renal Insufficiency Cohort (CRIC) study were analyzed. Structural social support (i.e., size, closeness, and frequency of contact with friends and family in each participant’s social network) was assessed among adults aged 60 years and older using the six-item Lubben Social Network Scale (LSNS-6). The LSNS-6 was administered between 2013 to 2018, the baseline for the current study. Follow-up occurred until death, study withdrawal, or December 2021. Poisson and Cox regression models assessed the association of social support with hospitalization and mortality risk, respectively.

Results: Of 2616 participants who completed the LSNS-6 (mean age [range] 71[65-85], 43% female, 45% non-Hispanic [NH] White, 41% NH Black, 11% Hispanic), 28% had low levels of social support. Over a mean follow-up of 6 years, 10535 hospitalizations and 774 deaths occurred. After adjusting for sociodemographic and clinical factors, greater social support was associated with a reduced risk of hospitalization (incidence rate ratio 0.88, 95% CI: 0.84–0.92). Similarly, greater social support was also associated with reduced mortality (mortality rate ratio 0.83, 95% CI: 0.70–0.97).

Conclusions: In this cohort of older adults with CKD, we found that higher levels of social support were associated with a reduced risk of hospitalizations and mortality. Future efforts should focus on identifying older adults with CKD with poor social support and to build, strengthen and maintain social networks.