Awareness of Chronic Kidney Disease among Tamil Nadu Population- ACross-sectional Study

Challenges for Public Campaigns to Improve the Health of Persons at High Risk of Developing CKD

Definition and Classification of CKD: The Debate Should Be About Patient Prognosis—A Position Statement From KDOQI and KDIGO

AIMTo determine the relationship between chronic kidney disease (CKD) awareness (CKD-A), self-management behaviors (CKD-SMB) knowledge, performance of CKD-SMBs, health literacy (HL) and kidney function.METHODSParticipants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-management knowledge tool (CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR (eGFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts.RESULTSOne-hundred-fifty patients participated in the study. eGFRs ranged from 17-152 mL/min per 1.73 m2. Majority (83%) of respondents had stage 3 or 4 CKD, low HL (63%), and were CKD aware (88%). Approximately 40% (10/25) of patients in stages 1 and 2 and 6.4% (8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage (P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents (≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, “controlling blood pressure” differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, “controlling blood pressure” (P = 0.02), and “keeping healthy body weight” (P = 0.01). Adjusted multivariate analyses between CKD-A and: (1) HL; and (2) CKD-SMB knowledge were non-significant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB (P < 0.05).CONCLUSIONCKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower eGFR, suggesting the need for focused patient education in CKD stages 1.

Awareness of CKD in China: A National Cross-sectional Survey

Among adults in the United States, 1 in 4 has hypertension and 1 in 8 has chronic kidney disease (CKD). Although the relationship between hypertension and CKD has been recognized for several hundred years, the prevalence of CKD among patients with normal blood pressure has not been assessed in randomly sampled populations. Crews et al1 in this issue of Hypertension are the first to report such estimates: 13.4% of people who have normal blood pressure have CKD. Among those with prehypertension, the prevalence is 17.3%; among those with undiagnosed hypertension, the prevalence is 22.0%; and among those with diagnosed hypertension, the prevalence is 27.4%. The magnitude of these CKD prevalence estimates is astounding and may even be misleading unless placed in appropriate context. The awareness of CKD diagnosis was dismal: <10% of people were aware of CKD regardless of hypertension category. A thorough analysis of the definition of CKD is necessary to understand how the varying definitions of CKD may have influenced both the prevalence and awareness estimates. The prevalence estimates may be inflated because of CKD that is so mild that it may not be considered a disease at all. For example, examination of the Figure (derived from Table 3 of the article) shows that if one considers the prevalence of more severe CKD defined as macroalbuminuria or estimated glomerular filtration rate (GFR) <45 mL/min per 1.73 m2, then the prevalence estimates fall dramatically. These stricter definitions of CKD yield the following prevalence estimates of CKD: normal blood pressure 0.5%; prehypertension 1.0%; undiagnosed hypertension 2.0%; and <5.0% prevalence of CKD among those with diagnosed hypertension. These prevalence estimates are much lower than those obtained with the more sensitive definition that is typically used to define CKD. Thus, the prevalence estimates of CKD may be driven up …

Background: Awareness and education of kidney disease has an impact on its effective management and will reduce the economic and public health burden. Objective: We conducted a cross-sectional descriptive study to assess the level of awareness, knowledge and common risk factors of CKD in the community to plan to preventive modalities. Patients and methods: We used a pretested validated questionnaire to gather information about sociodemographic knowledge and risk factors of CKD from 464 residents aged >18 years. Results: A total of 464 residents completed this study with a median age of 30 years, 50.5% of them were females. The mean knowledge score of chronic kidney disease (CKD) was relatively poor as it was 13.12% ± 3.95. Only 48.6% could mention at least one function of the kidneys with 66.4% agreeing with that certain medications can help to slow-down the worsening of chronic kidney disease. A laboratory test for kidney function was known by 75.9%. 92.9% and 17.2% believe that CKD can be cured by spiritual means and herbal concoctions respectively. Abdominal obesity and excessive stress were seen in 64.7% and 45.5% respectively. Hypertension was seen in 56.5% while diabetes mellitus was found in 57.1% as risk factors for chronic kidney disease. Conclusion: Efforts should be made to increase the public knowledge of CKD in Minia, Egypt as it was relatively poor that may be achieved by increasing awareness, education of people about CKD and how to prevent or regress its risk factors.

Associations Between Access to Care and Awareness of CKD

Chronic kidney disease and cardiovascular risk in six regions of the world (ISN-KDDC): a cross-sectional study.

Background: Data indicate lack of CKD awareness in T2D. Our study aimed to determine whether physician awareness of CKD in T2D is associated with CKD severity, and whether this changed over time. Methods: Retrospective study of adults (≥ 18 years) with an electronic health record (EHR) T2D diagnosis (Dx), seen in clinic in 3 sequential periods: 1/1/11-6/30/13, 7/1/13-12/31/15, and 1/1/16-6/30/19. CKD stages were defined by estimated glomerular filtration rate (eGFR; CKD-EPI creatinine-based) and albumin-to-creatinine ratio (ACR, spot urine). G1-G5 indicates eGFR CKD stages (mL/min/1.73m2) G1 &amp;gt;90, G2 89-60, G3a 45-59, G3b 30-44, G4 15-29, and G5 &amp;lt;15. A1-A3 indicates ACR stages (mg/g) A1 &amp;lt;30, A2 30-300, and A3 &amp;gt;300. The frequency of CKD stages was determined for all participants, regardless of EHR CKD Dx. Results: From 136,157 eligible patients (62±15 years; 53% male) seen during the study period, 77.9% had eGFR measured, 60.6% ACR, and 58.8% both. ACR was measured more often in less severe CKD stages (Chi-Square, p&amp;lt;0.001). For example, in period 1, ACR was assessed in 82.1%, 80.2%, 76.7%, 76.2%, 66.9%, and 48.1% from G1-5, respectively. Patients in G3a less often had a CKD Dx on their problem list than those in G3b-5 (Chi-Square, p&amp;lt;0.001). Among patients in G3a an EHR CKD Dx was present in 53.8%, 58.4%, and 60.1%, while among those in G3b-5 an EHR CKD Dx was present in 79.8%, 85.6%, and 84.9% in periods 1-3, respectively. Considering all patients in A2-3, an EHR CKD Dx was present in 44.9%, 44.5%, and 45.7% in periods 1-3, respectively. Conclusions: Consistent with published data, most patients with T2D and lab-diagnosed CKD do not have a CKD Dx in the EHR. Our study indicates that physician’s CKD awareness is associated with CKD severity as related to eGFR but not to ACR. Our data also indicates that despite an initial increase in eGFR-driven CKD awareness between periods 1 and 2, this has leveled off. Not having an EHR CKD Dx suggests lack of physician (and patient) CKD awareness and can potentially lead to suboptimal care. Disclosure J. Schempf: None. R.L. Freese: None. L. Caramori: Speaker’s Bureau; Self; Bayer Inc. Other Relationship; Self; Bayer Inc., Novartis Pharmaceuticals Corporation. T. Harindhanavudhi: None.

Prévalence de l’obésité et les principaux facteurs sociodémographiques associés au Maroc

BackgroundDespite the high and rising burden of chronic kidney disease (CKD) in South Asia, factors that influence access to CKD care at the community level have not been studied previously, especially in the rural areas. We conducted a mixed methods study and interviewed key stakeholders to explore the views and experiences of key stakeholders, and identify barriers and potential facilitators that influence access to CKD care at the primary care level in rural India.MethodsA total of 21 stakeholders participated in the study. We conducted 15 in-depth interviews on a purposive sample of stakeholders (CKD patients, healthcare providers and health planners) and one focus group discussion with 6 community health workers. The interviews were audio-recorded and transcribed verbatim. We employed the Lévesque’s framework for access to care to base interview guides and structure the initial codes. By inductive and deductive approaches, thematic analysis was undertaken using QSR NVivo version 11.ResultsThe major patient-level barriers to CKD care as reported by the most patients and healthcare providers was poor knowledge and awareness of CKD. Health system-level barriers included shortages of skilled healthcare professionals and medicines, fragmented referrals pathways to the specialists at the hospitals with inadequate follow up care. Many patients and healthcare providers, when asked about areas for improving access to CKD care, reported educational initiatives to increase awareness of CKD among healthcare providers and patients, provision of CKD related supplies, and a systems-level approach to care coordination including task shifting by engaging community health workers in CKD care, as potential facilitators.ConclusionsWe identified several barriers to access CKD care at the primary care level in rural India that need urgent attention. Targeted CKD screening programs and CKD specific educational initiatives may improve awareness of CKD. Additionally, primary care infrastructure needs to be strengthened for CKD care, ensuring trained staff, availability of essential diagnostics and medications, and creating efficient referral pathways for quality CKD care.

Background:Patient awareness of their chronic kidney disease (CKD) and health literacy (HL) are both important for adherence to therapies that slow CKD progression and to reduce risk of complications. Little is known about the association between HL and CKD awareness.Objective:We sought to determine if patient HL is associated with CKD awareness.Methods:We conducted a cross-sectional study of general medicine inpatients at an urban academic medical center discharged between June 2011 and July 2013 with CKD, defined as having at least one CKD International Classification of Diseases, ninth revision code (585.0–585.9), among their first 20 admission diagnoses. Logistic regression was used to analyze the influence of HL, demographic, clinical, and health care use covariates on the likelihood of patients' CKD awareness. Our primary outcome was patient awareness of their CKD, defined as correct patient self-report of “kidney problems.” We used the Brief Health Literacy Screen, a three-item verbal questionnaire, to assess HL.Key Results:Among 1,308 patients with CKD, awareness of CKD was 33%, and 48% had adequate HL. However, CKD awareness was not associated with HL even among patients with stage 4 or 5 CKD. In multivariable logistic regression, greater awareness was associated with being a woman, younger than age 50 years, married, White, having hypertension, and having a higher CKD stage (all p < .05). In stratified analyses, patients with hypertension had greater CKD awareness, regardless of HL or diabetes status (p < .05).Conclusions:Among hospitalized patients with CKD, both CKD awareness and HL are low and inadequate. Surprisingly, patients' knowledge of their CKD diagnosis was not related to patients' HL. Patients with hypertension who young, white, or married may be receiving or retaining more education related to CKD. More work is needed on how to effectively communicate CKD diagnosis to prevent widening health disparities. [Health Literacy Research and Practice. 2017;1(3):e117–e127.]Plain Language Summary:We studied whether patients with low health literacy also had low awareness of their chronic kidney disease (CKD). Hospitalized patients with CKD were asked three questions about their health literacy and whether they had “kidney problems.” Overall CKD awareness and health literacy were low, but a low score on one did not predict a low score on the other.

Background: Chronic kidney disease (CKD) has emerged as a major public health concern in Cameroon, particularly among individuals with hypertension and diabetes, who face significant barriers to effective disease management. Aim: This prospective cohort study aimed to assess CKD awareness, healthcare-seeking behaviours, and self-care management practices among hypertensive and/or diabetic patients at risk of CKD. Setting: The study was conducted from September 2022 to April 2024 among 400 participants attending four healthcare facilities in the Buea Health District, Cameroon. Methods: Structured questionnaires collected data on socio-demographics, clinical status, CKD knowledge and self-care adherence, with logistic regression analysing associations between risk factors and outcomes. Results: The study revealed alarming gaps in CKD knowledge, with only 35% of participants recognising hypertension and diabetes as primary risk factors. Misconceptions were widespread, including 90% falsely believing urine colour reliably indicates kidney health. Self-care practices were inconsistent: while dietary adherence was relatively high (97.3% avoided excess salt, 88.5% consumed vegetables regularly), critical monitoring behaviours were neglected – only 15.2% underwent regular renal check-ups, and 29.8% monitored blood pressure at home. Hypertension was strongly associated with CKD (adjusted odds ratio [OR] = 4.28, 95% confidence interval [CI]: 1.25–14.67), whereas diabetes alone showed no significant link. Socio-demographic disparities further compounded these challenges, with tertiary-educated participants demonstrating better CKD awareness than those with primary education (p &lt; 0.05). Conclusion: These findings underscore systemic deficiencies in CKD prevention and management, including poor health literacy, financial barriers and inadequate healthcare infrastructure. Contribution: To mitigate CKD’s growing burden, policymakers must prioritise community-based education, subsidised screening programmes and improved access to monitoring tools. Culturally tailored interventions, integrating patient empowerment and health system strengthening, are urgently needed to enhance early detection and long-term outcomes in resource-limited settings like Cameroon.

Chronic kidney disease from screening, detection, and awareness, to prevention.

Introduction&#x0D; The number of new dialysis acceptance and dialysis prevalence rate in Malaysia has been increasing steadily for the past 10 years, and forecasting models predict that these numbers will continue to increase. Chronic Kidney Disease (CKD) awareness may slow the progression of CKD. As CKD awareness is dependent upon general knowledge of CKD, assessing the knowledge of CKD of the local population is important, to direct future CKD education efforts.