Chronic Kidney Disease Awareness Among Individuals with Clinical Markers of Kidney Dysfunction

Abstract

SummaryBackground and objectives Awareness of chronic kidney disease (CKD) among providers and patients is low. Whether clinical cues prompt recognition of CKD is unknown. We examined whether markers of kidney disease that should trigger CKD recognition among providers are associated with higher individual CKD awareness.Design, setting, participants, & measurements CKD awareness was assessed in 1852 adults with an estimated GFR Ͻ60 ml/min per 1.73 m 2 using 1999 to 2008 National Health and Nutrition Examination Survey data. CKD awareness was a "yes" answer to "Have you ever been told you have weak or failing kidneys?" Participants were grouped by distribution of the following abnormal markers of CKD: hyperkalemia, acidosis, hyperphosphatemia, elevated blood urea nitrogen, anemia, albuminuria, and uncontrolled hypertension. Odds of CKD awareness associated with each abnormal marker and groupings of markers were estimated by multivariable logistic regression.Results Among individuals with kidney disease, only those with albuminuria had greater odds of CKD awareness (adjusted odds ratio, 4.0, P Ͻ 0.01) than those without. Odds of CKD awareness increased with each additional manifested clinical marker of CKD (adjusted odds ratio, 1.3, P ϭ 0.05). Nonetheless, 90% of individuals with two to four markers of CKD and 84% of individuals with Ն5 markers of CKD were unaware of their disease. ConclusionsAlthough individuals who manifest many markers of kidney dysfunction are more likely to be aware of their CKD, their CKD awareness remains low. A better understanding of mechanisms of awareness is required to facilitate earlier detection of CKD and implement therapy to minimize associated complications.

Letramento funcional em saúde e conhecimento de doentes renais em tratamento pré-dialítico

“…Knowledge is the result of information interpretation and its association with vicarious experiences of each individual (24) . The results of this research, the insufficient knowledge was related to age, cognitive impairment and years of education confirming the completion of other polls which also indicate that individuals with low schooling and with advanced age present insufficient knowledge about the disease and treatment (25) . Age and time of treatment were associated with insufficient knowledge, although in research with children (13) .…”

Remote Usability Testing and Satisfaction with a Mobile Health Medication Inquiry System in CKD

“…This shift in focus has resulted in a growing emphasis on patient engagement and the incorporation of digital solutions to support patient self-management practices (15,16). Individuals with CKD, often characterized by low disease awareness, limited health literacy, and frequent interactions with the health care system (17,18), are at high risk of adverse safety events related to their care, such as drug-related problems. This opens potential to introduce tailored digital tools to this population as patient-initiated safeguards (7,(19)(20)(21)(22).…”

Validation of an Albuminuria Self-assessment Tool in the Multi-Ethnic Study of Atherosclerosis (MESA)

“…5,[13][14][15][16][17] In a prior analysis of MESA data, albuminuria was associated with higher mean end-diastolic left ventricular mass and coronary artery calcification scores. 18 In other studies, albuminuria has been associated with an increased risk for CVD events, ESRD, and death.…”