Knowledge, attitude, and practices regarding renal diets among predialysis chronic kidney disease in Lucknow, India

Abstract

Background: There is a paucity of data with respect to the knowledge, attitude, and practices (KAP) of patients with predialysis chronic kidney disease (CKD) regarding dietary restrictions and advice. The primary objective of the study was to assess KAP and its determinants in adult predialysis CKD patients visiting outpatient nephrology services. Methods: An existing KAP questionnaire used earlier in CKD dialysis population was utilized with modification for use in the region of interest. The total score was 55, knowledge score had three domains with 10 food items, and attitude and practice scores had seven and six questions, respectively. Adult patients with CKD not on dialysis were selected for the study, provided they were regularly visiting outpatient nephrology and dietetics services. Other sociodemographic, anthropometric, medication use, and laboratory variables were also noted, after the administration of the structured questionnaire by the same investigator in the local language. Results: A total of 111 patients were recruited to the study, with median age of 47 years, 60% of males, 70% from rural areas, up to 50% illiterate, >80% unemployed, and >60% belonging to lower socioeconomic status. Despite these, the majority (>70%) had adequate knowledge, though median attitude and practice score percentages were lower at 64% and 66%, respectively. Higher practice scores correlated significantly with higher serum albumin, higher socioeconomic status, and reduced phosphate binder use. Conclusion: The present study population, which was under regular nephrology and dietetics outpatient follow-up, showed adequate knowledge regarding renal diet, but required improvement in attitudes and practices, for which novel approaches need to be applied with team effort.