Independent correlates of chronic kidney disease awareness among adults with type 2 diabetes

Abstract

BackgroundChronic Kidney Disease (CKD) is usually silent until advanced stages. Awareness of CKD is important to mitigate poorer outcomes. This study aims to understand the relationship(s) between CKD self-awareness and diagnosed CKD. MethodsThe study included 345 adults with type 2 diabetes from two primary care settings. Participants completed surveys assessing demographic information, self-care behaviors and co-morbidities. Biological data were taken from medical records. CKD was diagnosed as eGFR=<59ml/min. CKD awareness was defined by a positive response to "has a doctor, nurse or other health professional ever told you that you have a kidney disease?" and/or "have you ever had kidney failure that required dialysis or a kidney transplant?" Logistic regression models were used to examine the association between CKD awareness and clinical/socio-demographic variables. Results31% of study patients had CKD based on eGFR (of which only 63% were aware). Stepwise regression showed that non-Hispanic blacks (OR=3.49, p=0.04), those with college education (OR=8.02, p=0.01), history of myocardial infarction (OR=10.12, p=0.002) or hypertension (OR=23.25, p=0.02), and those with Medicare, VA insurance, or other insurance (OR=8.08, 8.72, 101.47, respectively, p<0.01) were significantly more likely to be aware of CKD. Those with a history of stroke or depression (OR=0.21, 0.28, respectively, p=0.03, p=0.04) were significantly less likely to be aware of CKD. ConclusionCKD awareness was found to be lower than diagnosed CKD rates. Factors associated with awareness include race, educational status and cardiovascular disease. Targeted strategies to increase CKD awareness may lead to improved health outcomes.