CKD Awareness Among US Adults by Future Risk of Kidney Failure

Chu, Chi D.; McCulloch, Charles E.; Banerjee, Tanushree; Saran, Rajiv; Tuot, Delphine S.; Shahinian, Vahakn B.; Heung, Michael; Gillespie, Brenda W.; Morgenstern, Hal; Herman, William H.; Zivin, Kara; Bragg‐Gresham, Jennifer L.; Steffick, Diane; Han, Yun; Zhang, Xiaosong; Li, Yiting; Kurtz, Vivian; Wyncott, April; Powe, Neil R.; Hsu, Chi‐yuan; Crews, Deidra C.; Hsu, Raymond K.; Johansen, Kirsten L.; Shlipak, Michael G.; Canela, Janet; Burrows, Nilka Ríos; Eberhardt, Mark S.; Mondesire, Juanita; Patel, Priti R.; Pavkov, Meda E.; Rolka, Deborah B.; Saydah, Sharon; Shrestha, Sundar S.; Waller, Larry

doi:10.1053/j.ajkd.2020.01.007

Cited by 86 publications

(69 citation statements)

References 36 publications

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“…The high prevalence of CKD and low CKD awareness among both physicians and the general population have been documented in Taiwan and worldwide [ 36 , 37 , 38 , 39 ]. A study by Chen et al, including 248 HT recipients in a single center in Taiwan, reported renal dysfunction before transplant in 8% of patients [ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes and Risk Factors of Renal Failure Requiring Dialysis after Heart Transplantation: A Nationwide Cohort Study

Wang

Lin

Wei

et al. 2020

JCM

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Acute kidney injury and renal failure are common after heart transplantation. We retrospectively reviewed a national cohort and identified 1129 heart transplant patients. Patients receiving renal replacement therapy after heart transplantation were grouped into the dialysis cohort. The long-term survival and risk factors of dialysis were investigated. Patients who had undergone dialysis were stratified to early or late dialysis for subgroup analysis. The mean follow-up was five years, the incidence of dialysis was 28.4% (21% early dialysis and 7.4% late dialysis). The dialysis cohort had higher overall mortality compared with the non-dialysis cohort. The hazard ratios of mortality in patients with dialysis were 3.44 (95% confidence interval (CI), 2.73–4.33) for all dialysis patients, 3.58 (95% CI, 2.74–4.67) for early dialysis patients, and 3.27 (95% CI, 2.44–4.36; all p < 0.001) for late dialysis patients. Patients with diabetes mellitus, chronic kidney disease, acute kidney injury, and coronary artery disease were at higher risk of renal failure requiring dialysis. Cardiomyopathy, hepatitis B virus infection, and hyperlipidemia treated with statins were associated with a lower risk of renal dysfunction requiring early dialysis. The use of Sirolimus and Mycophenolate mofetil was associated with a lower incidence of late dialysis. Renal dysfunction requiring dialysis after heart transplantation is common in Taiwan. Early and late dialysis were both associated with an increased risk of mortality in heart transplant recipients.

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Section: Discussionmentioning

confidence: 99%

Long-Term Outcomes and Risk Factors of Renal Failure Requiring Dialysis after Heart Transplantation: A Nationwide Cohort Study

Wang

Lin

Wei

et al. 2020

JCM

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“…In agreement with numerous reports from diverse countries and population-based studies, more women than men have an eGFR indicative of CKD stages G3-G5 [10]. Yet, our findings update previous reports [22][23][24] and suggest that despite this increased disease prevalence among women compared with men, CKD awareness is consistently lower amongst women. Examining serum creatinine alone is an insensitive method of detecting CKD [34], and it could be postulated that the naturally lower creatinine in women (who tend to have lower muscle mass than men) has been interpreted as an absence of CKD.…”

Section: Plos Onesupporting

confidence: 92%

“…Despite the advances of the nephrology community in standardizing and simplifying the diagnosis and stratification of CKD [49], and after efforts in the dissemination of the importance of identification of the disease and understanding of its burdens to patients and healthcare systems [50], still only roughly 20% of CKD classified patients self reportedly claim to ever have been told they have weak or failing kidneys by a health professional, consistent with previous reports [22][23][24]. Due to the lack of signs and symptoms in the early stages of CKD, only active screening of CKD in high risk population will lead to early identification of the disease, which is currently recognized as cost effective in a high risk population [49].…”

Section: Discussionsupporting

confidence: 65%

“…Prior research documented generally low awareness rates of CKD in the US population with little improvement over time [22,23], even in the most recent analysis through the year 2016 [24]. Specifically, CKD awareness rates consistently amounted to 10% and below for patients with CKD stage G3, and even lower for earlier stage CKD where level of albuminuria constitutes the disease-qualifying criterion.…”

Section: Plos Onementioning

confidence: 98%

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“…Using a diverse racial and socioeconomic population in Baltimore City, Tuot et al 3 found that only 20% of participants were aware of having CKD (range, 11% for CKD stages 1 and 2 and 29% for CKD stages 3 and 4). Similarly, Chu et al 4 found that between 2011 and 2016, CKD awareness ranged from 10% to just 49% among low- and high-risk groups, respectively. Tummalapalli et al 5 found that of 6,529 participants with CKD, just 4.4% were aware of their CKD.…”

Section: What Information Should Be Communicated Earlier In the Diseamentioning

confidence: 91%