In North American children with chronic kidney disease (CKD), poverty correlates with faster disease progression. As an aspect of poverty, food insecurity is common among these children, yet its impact on CKD progression is underexplored. The purpose of this study was to assess the impact of food assistance (FA) on CKD progression by comparing the cumulative incidence and the hazard of kidney replacement therapy (KRT) initiation in those who reported receiving FA to those who did not.