Awareness of kidney disease in the US population: Findings from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2000

Nickolas, Thomas L.; Frisch, Gershon; Opotowsky, Alexander R.; Arons, R. M.; Radhakrishnan, Jai

doi:10.1053/j.ajkd.2004.04.023

Cited by 96 publications

(77 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is in line with data that most individuals with minor renal damage are not aware of this (7). Of note, we found little overlap among the three groups with putative renal risk markers.…”

Section: Discussionsupporting

confidence: 78%

“…The National Health and Nutrition Examination Survey (NHANES) indeed showed a low awareness of chronic kidney disease (CKD) among patients with Kidney Disease Outcomes Quality Initiative (K/DOQI) stages 1 through 4 for CKD. Only in the last stage of CKD, which is characterized by a GFR Ͻ15 ml/min, were most patients aware of their illness (7,8). Considering this, it is necessary to develop screening strategies for the early identification of people who are at risk for accelerated renal function loss and may benefit from preventive treatment strategies.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Macroalbuminuria Is a Better Risk Marker than Low Estimated GFR to Identify Individuals at Risk for Accelerated GFR Loss in Population Screening

Halbesma

Kuiken²,

Brantsma³

et al. 2006

Journal of the American Society of Nephrology

179

114

View full text Add to dashboard Cite

Macroalbuminuria, erythrocyturia, and impaired renal function are strong predictors of poor renal outcome in patients with known renal disease. However, the yield of mass screening for these variables to identify individuals who are at risk for GFR loss is yet unknown in a Western population. With the use of data from the Prevention of Renal and Vascular End-Stage Disease (PREVEND) study, a prospective, population-based cohort study, the cardiovascular and renal prognosis was investigated in patients with classical renal risk markers: Macroalbuminuria (>300 mg albumin/24 h urine), erythrocyturia (>250 erythrocytes/L, without leukocyturia), and impaired renal function (both 24-h creatinine clearance and Modification of Diet in Renal Disease clearance below the fifth percentile of age-and gender-matched control subjects). The 8592 patients who were included in this study were followed for a 4-yr period. We identified 134 patients with macroalbuminuria, 128 with erythrocyturia, and 103 with impaired renal function. There was only a little overlap among the three groups. The prevalence of macroalbuminuria, erythrocyturia, and impaired renal function was calculated to be in the general population 0.6, 1.3, and 0.9%, respectively. In all three groups, fewer than 30% of patients were known to have this laboratory abnormality before screening. The incidence of cardiovascular disease was high in the macroalbuminuria group (e.g., the age-and gender-adjusted hazard ratio for mortality as a result of cardiovascular disease is 2.6 [1.1 to 6.0]) and for the impaired renal function group (3.4 [1.5 to 8.0]). After a mean follow-up of 4.2 yr, the macroalbuminuria group showed a ؊7.2 ml/min per 1.73 m 2 estimated GFR (eGFR) loss, compared with ؊2.3 ml/min per 1.73 m 2 in the control group (difference P < 0.001), whereas the rate of eGFR loss in the impaired renal function group (؊0.2 ml/min per 1.73 m 2 ; P ‫؍‬ 0.18) and the erythrocyturia group (؊2.6 ml/min per 1.73 m 2 ) was not different from the control group. Macroalbuminuria and impaired renal function both predict a worse prognosis with respect to cardiovascular morbidity and mortality. However, macroalbuminuria is a better risk marker than low eGFR or erythrocyturia to identify in population screening of individuals who are at risk for accelerated GFR loss.

show abstract

Section: Discussionsupporting

confidence: 78%

mentioning

confidence: 99%

Macroalbuminuria Is a Better Risk Marker than Low Estimated GFR to Identify Individuals at Risk for Accelerated GFR Loss in Population Screening

Halbesma

Kuiken²,

Brantsma³

et al. 2006

Journal of the American Society of Nephrology

179

114

View full text Add to dashboard Cite

show abstract

“…A large study performed in the United States population showed that 16.8% of the population aged Ն20 years has CKD (4). Many of these individuals are not aware of having CKD (5). On the basis of these results, screening for CKD has been suggested.…”

Section: Introductionmentioning

confidence: 99%

Development and Validation of a General Population Renal Risk Score

Halbesma¹,

Jansen

Heymans

et al. 2011

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

SummaryBackground and objectives There is a need for prediction scores that identify individuals at increased risk for developing progressive chronic kidney disease (CKD). Therefore, this study was performed to develop and validate a "renal risk score" for the general population.Design, setting, participants, & measurements For this study we used data from the PREVEND (Prevention of Renal and Vascular ENdstage Disease) study, a prospective population-based cohort study with a median follow-up of 6.4 years. Participants with two or three consecutive estimated GFR (eGFR) measurements during follow-up were included. Participants within the group who had the most renal function decline (top 20% of the total population) and had an eGFR value Ͻ60 ml/min per 1.73 m 2 during follow-up were defined as having progressive CKD. Possible predictors for progressive CKD were selected on the basis of univariable logistic regression analyses.Results A final prediction model was built using backward logistic regression analysis. Besides baseline eGFR, the model contained age, urinary albumin excretion, systolic BP, C-reactive protein, and known hypertension. The area under the receiver operating characteristic (ROC) curve was 0.84. We performed internal validation by using a bootstrapping procedure. As expected, after the regression coefficients were corrected for optimism, the area under the ROC curve was still 0.84. For clinical use we divided all predictors in meaningful clinical categories to develop a score chart. The area under the ROC curve was 0.83, indicating the high discriminative value of this model. ConclusionsGiven the high internal validity of this renal risk score, this score can be helpful to identify individuals at increased risk for progressive CKD.

show abstract

“…Despite these known adverse consequences of CKD, the majority of persons with the disease, especially prior to ESRD, remain unaware of their disease [17][18][19]. Awareness of CKD remains unacceptably low, despite recent attempts to increase awareness through dissemination of clinical practice guidelines and recommendations for patients with CKD or its risk factors to providers [20][21][22], including community awareness events such as World Kidney Day [23,24].…”

Section: Introductionmentioning

confidence: 99%

Doctors’ knowledge and practices regarding chronic kidney disease at a tertiary care hospital

et al. 2016

View full text Add to dashboard Cite

Background: The complications of chronic kidney disease (CKD) significantly contribute to morbidity and mortality, therefore clinical practice guidelines have been developed to facilitate early detection and treatment. However, given the high prevalence of CKD, many patients with early CKD are seen by non-nephrologists, who need to be aware of CKD complications, screening methods and treatments goals in order to initiate timely therapy and referral.Methods: This was a cross-sectional study conducted at three campuses of the Ziauddin University Hospital, Karachi, Pakistan in 2016. A questionnaire based survey was conducted to assess the knowledge and practices of doctors from various specialties regarding CKD.Results: We performed a questionnaire based survey to assess knowledge and practice patterns in CKD care among 156 doctors. There were 63 male and 50 female respondents. There were 24 attending doctors, 73 post-graduate trainees and 25 house-officers. Our data showed that although CKD risk factors are generally recognized, there is a paucity of knowledge regarding CKD management guidelines and staging of CKD. There is an awareness regarding timely referral to nephrology, but many would still not refer at the appropriate stage. Many also do not use standard equations to calculate Glomerular Filtration rate (GFR) and Creatinine Clearance]. Most do screen for diabetic nephropathy, know about ACE-I/ARBs and provide dietary counseling to CKD patients. The majority do not read medical journals to keep their knowledge up-to-date. Junior doctors (post-graduate trainees and house-officers) fared better than attending doctors in the knowledge and practice parameters.

show abstract

Awareness of kidney disease in the US population: Findings from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2000

Cited by 96 publications

References 27 publications

Macroalbuminuria Is a Better Risk Marker than Low Estimated GFR to Identify Individuals at Risk for Accelerated GFR Loss in Population Screening

Macroalbuminuria Is a Better Risk Marker than Low Estimated GFR to Identify Individuals at Risk for Accelerated GFR Loss in Population Screening

Development and Validation of a General Population Renal Risk Score

Doctors’ knowledge and practices regarding chronic kidney disease at a tertiary care hospital

Contact Info

Product

Resources

About