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

Abstract

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. Conclusion: Our survey shows that there is a requirement for continuing education and awareness among doctors regarding CKD and its management guidelines, as well as timely referral to a nephrologist. Facing a growing CKD incidence, doctors can have an impact on preventing its progression and associated complications with increased familiarity of local guidelines.