Knowledge Of Chronic Kidney Disease Research Articles

Characterization of CKD illness representation profiles using patient-level factors.

Illness perceptions are the unique perspective individuals have on their illness, based on their context and experiences, and are associated with patient outcomes including coping and adherence. The purpose of this study was to explore characteristics that may be driving membership in illness perceptions cluster groups for adults with chronic kidney disease (CKD). This study was conducted within the multicenter longitudinal Chronic Renal Insufficiency Cohort (CRIC) Study. Cross-sectional data were collected and combined with CRIC data. Illness perceptions were measured using the Revised Illness Perception Questionnaire. Clustering analysis was conducted in R, and bivariate analysis including linear regression was performed in STATA 16. The sample (n = 197) had a mean age of 68, was 52% women, 53% non-White, and mean estimated glomerular filtration rate (eGFR) 56 ml/min/1.73 m2. Three cluster groups were identified, labeled as "Disengaged" (n = 20), "Well-Resourced" (n = 108), and "Distressed" (n = 69). The "Disengaged" group was characterized by low CKD knowledge, many recent hospitalization days, and the lowest perceived CKD burden. The "Well-Resourced" group was characterized by the highest levels of education, CKD knowledge, optimism, and medication adherence. The "Distressed" group was characterized by the highest levels of depression scores, comorbidity burden, CKD burden, CKD symptoms, and lowest optimism. Group membership significantly predicted the number of hospitalization days in adjusted analyses. Illness perceptions groups are associated with number of hospitalization days but are independent of many patient characteristics. Illness perceptions data could be used to tailor care for specific patients at risk for poor health outcomes.

Exploring Patient Needs and Preferences in CKD Education: A Cross-Sectional Survey Study.

Despite efforts to educate individuals with chronic kidney disease (CKD) and thereby improve outcomes, studies have shown that a significant number of patients still report poor CKD knowledge. Thus, understanding patient needs and preferences is crucial for the development and implementation of an effective CKD educational program. A paper survey was distributed to CKD patients ≥ 21 years at a tertiary care hospital's outpatient nephrology clinic in Rochester, New York. Data on patient demographics, print and technological literacies, and preferences regarding topics, instructors, class formats, session frequency, duration, and peer support were gathered. Of the 337 patients, the mean age was 65 years (± 12.33 years), and the self-identified races were: American Indian or Alaska Native (<1%), Asian (3%), Black or African American (12.17%), Native Hawaiian or other Pacific Islander (<1%), White (83%), and Other (2%). Most patients (69%) never needed help with health instructions and 68% of patients used a smartphone or computer everyday. Key topics identified by patients included the definitions of CKD, creatinine, GFR and kidney diet. 73% of patients desired more than basic CKD information with 1 in 5 even wanting to know "everything a doctor knows." 46% were willing to attend classes and 33% preferred using digital (video, computer, smartphone) modalities. Patients were willing to attend an average of 3.6 classes and, most preferred hour-long classes. Most patients (46%) preferred a doctor as educator and 53% expressed interest in connecting with fellow patients for peer support. Most CKD patients are interested in comprehensive education about their disease. This research may offer insights into the optimal content and delivery of CKD educational programs by elaborating on patients' needs and the integration of online modalities to deliver content. Future person-centered educational programs for people with CKD are needed.

Awareness of chronic kidney disease and the perception of the community towards organ donation and renal transplantation in Riyadh province of Saudi Arabia

Background: Chronic kidney disease (CKD) is a significant health problem associated with increased mortality and morbidity. Awareness of CKD in people is crucial to decrease mortality, morbidity, and complications. CKD can lead to end-stage renal failure that needs renal transplantation. Objectives: This study aimed to evaluate the awareness of chronic kidney disease and the community's perception of organ donation and renal transplantation. Methods: This cross-sectional study was conducted on 503 Saudi adults between June and September 2022 in Riyadh Province of Saudi Arabia. We distributed online self-administered questionnaires among the general adult population utilizing convenient sampling. Results: Most of the participants had university degrees (67.2%). Of the total, 40.6%, 24.5% and 29.2% of participants knew that painkillers, hypertension (HTN) and diabetes mellitus (DM) are risk factors for CKD, respectively. A significant relationship was observed between knowledge about risk factors of CKD and educational level (p&lt;0.05), but an insignificant relation with gender (p&gt;0.05). Most of the participants (53.3%) supported organ donation, and a significant relationship was observed with the gender and educational level of participants (p&lt;0.05). Conclusion: The current study showed low awareness of CKD and poor knowledge about kidney transplantation and organ donation in the community of Saudi Arabia. Mass media and campaigns can be central in raising awareness about CKD and organ donation to help facilitate disease identification and prevention. Keywords: Chronic renal disease, hypertension, diabetes mellitus, non-steroidal anti-inflammatory drugs, attitude

Assessment of Public Knowledge about Chronic Kidney Disease and Factors Influencing Knowledge Levels: A Cross-Sectional Study.

Background and Objectives: Chronic kidney disease (CKD) poses a significant risk for end-stage renal disease (ESRD), cardiovascular diseases, and premature death. The study aims to assess CKD knowledge and predictive variables among the general public. Materials and Methods: A cross-sectional study was conducted among the general public in Al Medina Al-Munawara, Saudi Arabia, utilizing a 21-item questionnaire-based approach over a 4-month period from January 2023 to April 2023. The developed questionnaire was validated for readability by experts and refined in light of the feedback received from the experts and the final version was prepared. The reliability of the questionnaire was 0.71, which shows an acceptable level of internal consistency. The data analysis was performed using IBM SPSS software (version 25). Results: A total of 777 complete surveys were received after applying the exclusion criteria. The study results revealed that the majority of the respondents had poor knowledge 505 (65%), 203 (26.1) had moderate knowledge, and 69 (8.9%) had good knowledge. Gender (p = 0.004), age (<0.001), education level (p = 0.039), marital status (p = 0.003), and occupation (p = 0.002) play significant roles in shaping participants' knowledge levels regarding CKD. Lower odds of good knowledge were associated with females with an OR (95% CI) of 0.448 (0.263-0.764) and intermediate or higher secondary school level of education displayed an OR (95% CI) of 0.39 (0.18-0.89). Higher odds of good knowledge levels were associated with the age group of 18-27 with an OR (95% CI) of 5.077 (1.21-21.38) and being employed with an OR of 3.555 (1.04-12.21). Conclusions: A significant proportion of respondents had poor knowledge about CKD. Several demographic factors were associated with CKD knowledge. Further research is needed to explore these knowledge disparities and develop targeted interventions to improve CKD knowledge among the general public.

Awareness of chronic kidney disease and its risk factors in the former Soviet Union countries

&lt;b&gt;Purpose:&lt;/b&gt; Assessment of public knowledge of chronic kidney disease (CKD) is an essential step in&lt;b&gt; &lt;/b&gt;development of CKD prevention and screening programs. Our aim was to estimate the level of public CKD knowledge and its predictors in the former Soviet Union countries using a validated questionnaire.&lt;br /&gt; &lt;b&gt;Materials and methods: &lt;/b&gt;This cross-sectional survey was conducted in 10 countries using an adapted validated online questionnaire. Descriptive statistics were used to describe participants’ characteristics and assess public CKD knowledge level. A multiple linear regression analysis was performed to identify predictors of CKD knowledge.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;2,715 participants satisfied the inclusion criteria. Respondents having higher level of education, living in countries belonging to the lower middle-income countries, having a personal history of diabetes and hypertension, and having a family history of kidney disease showed significantly better CKD knowledge.&lt;br /&gt; &lt;b&gt;Conclusions:&lt;/b&gt; The level of CKD knowledge among the population of post-Soviet states was found to be low, although some personal characteristics were associated with better CKD knowledge.

Community Knowledge and Self-Awareness on Risk Factors for Chronic Kidney Disease (CKD) in Bali, Indonesia

Introduction: In Indonesia, CKD is among the top 10 most prevalent diseases, with the prevalence increasing sharply from 2013 to 2018. Therefore, prevention should focus on reducing risk factors for people who have not yet suffered from CKD. Based on the above, researchers are interested in examining the relationship between knowledge and community self-awareness of CKD risk factors in Bali.&#x0D; Methods: This study used descriptive analysis with a cross-sectional approach. The population in the study was all Balinese people, with a sample size of 209 respondents who met the inclusion criteria. The research was conducted by means of an online survey consisting of demographic data, Self-Awareness Questionnaire and CKD Knowledge Questionnaire through Google Forms. The collected data were analyzed with univariate and bivariate analyses.&#x0D; Results: Most of the respondents were from adolescence to early adulthood (17–35 years old)—as many as 78.2%, dominated by women (64.8%). Judging from the level of knowledge, more than half of the respondents fell into the sufficient category, namely 67%. While the level of community self-awareness tends to be high, with a result of 45%, Thus, there was a significant relationship between knowledge and self-awareness of the Balinese community towards CKD risk factors (p&lt;0.01).&#x0D; Conclusion: Balinese people have a good level of knowledge and awareness of CKD risk factors. However, preventive measures are still needed to prevent an increase in these cases. It is hoped that health services would continue to provide information.

Related Factors with Self-Management Behaviors among Patients with Predialysis Chronic Kidney Disease: A Multicenter Study in Myanmar

Background: Self-management behavior is key to managing patients with predialysis chronic kidney disease (CKD) and is effective in slowing disease progression in impoverished Burmese patients with CKD. This study aimed to outline the association of personal and environmental factors with the self-management behaviors of people with predialysis CKD. Methods: Using convenience sampling, this cross-sectional study included 84 individuals with predialysis CKD from two private hospitals in Myanmar. The interviewer-administered questionnaire included demographic information, the Health Literacy Short Form-12, the CKD knowledge questionnaire, the self-efficacy questionnaire, the Multidimensional Scale of Perceived Social Support, and the self-management behavior questionnaire. This study analyzed the data using descriptive statistics, Pearson’s correlation coefficients, Spearman’s rho correlation, and Chi-square tests. Results: The results revealed that participants had moderate health literacy (26.12 ± 7.51), CKD knowledge (10.10 ± 3.76), and perceived self-efficacy levels (30.58 ± 10.28), a high social support level (67.33 ± 8.54), and a moderate self-management behavior level (74.20 ± 7.80). Health literacy (r = 0.40, p &lt; 0.01), CKD knowledge (r = 0.62, p &lt; 0.01), perceived self-efficacy (r = 0.62, p &lt; 0.01), and social support (r = 0.44, p &lt; 0.01) were related to self-management behaviors. Conclusions: The results indicated that enhanced health literacy, CKD knowledge, self-efficacy, and social support could support the self-management behaviors of individuals with predialysis CKD.

CKD Knowledge and Its Associated Factors Among Patients with Type 2 Diabetes Mellitus Attending Follow-up in a Penang Primary Health Clinic

Objective: Information regarding the level of chronic kidney disease (CKD) knowledge and its associated factors among high-risk patients is crucial for the planning of CKD prevention strategies. This study aimed to determine the level of CKD knowledge and its associated factors among patients with a recent diagnosis of diabetes mellitus (DM) attending follow-ups at a primary healthcare clinic in Penang. Material and Methods: This cross-sectional study involved the consecutive sampling of 100 recently diagnosed DM patients (within 5 years) attending diabetic follow-up at the Kepala Batas Health Clinic. The level of CKD knowledge was assessed using a self-administered validated questionnaire. Demographic characteristics were described using frequencies, percentages, means and standard deviations. Associated factors of CKD knowledge were determined using multiple logistic regression analysis. The level of statistical significance was set at p-value&lt;0.05. Results: As high as 81.0% of the participants scored less than four out of seven marks for CKD knowledge. The mean score was 2.61, while the median score was 3.0. Educational level was identified as the single determinant of CKD knowledge among the study participants.Conclusion: In this study, patients with a recent diagnosis of DM attending follow-up in primary healthcare showed a poor level of CKD knowledge. To ensure the success of the CKD prevention programme among high-risk groups, healthcare providers must provide relevant and effective education to all diabetic patients in the early phase after DM diagnosis; particularly among those with a lower education background. 

Access to chronic kidney disease (CKD) care: Its barriers and facilitators in a community development block in Purba Bardhaman, West Bengal: A qualitative study.

Chronic kidney disease (CKD), a leading public health problem, has potential risks and serious implications on the health of individuals and society at large. Few studies explored the factors that influence access to CKD care at the community level in rural areas of West Bengal. A qualitative study was planned among key stakeholders to explore their views and experiences and to identify the barriers and potential facilitators that influence access to CKD care at the primary care level. Total 23 stakeholders participated in the study. Seventeen in-depth interviews (IDIs) were conducted on a purposive sample of stakeholders (CKD patients, healthcare providers (HCPs) and health planners) and one focus group discussion (FGD) among six community health workers. The audio-recorded interviews were transcribed verbatim. The Lévesque's framework for access to care as modified by Jodie Bailie et al. was employed to construct interview guides and structure the initial codes. Thematic analysis was undertaken using QSR NVivo version 11 using both inductive and deductive approaches. The major barriers to CKD care at patient level were poor knowledge and awareness of CKD and at the health system level was shortage of skilled staffs, diagnostics and medicines and fragmented referrals. The potential facilitators identified were educational activities to increase the awareness of CKD among HCPs and patients; provision of CKD-related supplies and a system-level approach to care coordination along with m-health-based care. Targeted CKD screening programs and CKD specific trainings may improve awareness of CKD. Additionally, stronger primary care infrastructure, availability of essential drugs and diagnostics and creating an efficient referral process for the quality CKD care are the need of the hour.

Chronic kidney disease acquired knowledge in a diabetic and hypertensive population using a translated and validated questionnaire

Chronic kidney disease (CKD) is the progressive and irreversible functional and/or structural impairment of the kidney; its main etiologies include hypertension and diabetes. Mexico has the second highest prevalence of CKD worldwide with a high economic burden affecting public and private health systems. Patients with higher knowledge about CKD increase their adherence to preventive treatment. In this study we aim to describe the knowledge of CKD in a sample of Mexican high-risk population, comparing it with general Mexican population, medical students and nephrologists. A cross-sectional, observational study was performed divided in two phases: translation and validation of the knowledge questionnaire to Spanish, and cross-sectional survey to evaluate the knowledge of CKD in patients with diagnosis of diabetes and/or hypertension. We interviewed medical students, general population, and nephrologists to attain validation of the questionnaire in Spanish. The questionnaire was answered by 1,061 participants within the high-risk population. The results of the questionnaire were: 22/24, 18/24, 13.8/24, and 13.4/24 in nephrologists, medical students, normal subjects, and high-risk population, respectively. The questions with least correct answers were related to kidney functions and CKD risk factors. To our knowledge this is the first time a questionnaire for CKD knowledge is applied in Mexican population. These findings suggest poor understanding of kidney functions, risk factors, and symptoms of CKD. It is important not only to provide medical treatment to chronic illness but also awareness of the consequences of not achieving goals of treatment.

#3639 WHEN WHOLE EXOME SEQUENCING IS NOT GOOD ENOUGH: BACK TO THE ROOTS OR FORWARD TO THE FUTURE

Abstract Background and Aims Over the last few years, massively parallel sequencing (MPS) has been established in genetic diagnostics, where large virtual panels of candidate genes can be screened on a whole exome basis. This has enabled large analyses for most medical indications, including renal genetic diseases. The 25 year old, index female patient was referred for disease clarification. Both non-related parents suffered from end-stage renal disease, with kidney failure in mid adulthood and familiar cystic disease in both the maternal and paternal lines. An external genetic analysis applying MPS on a restricted panel of genes retrieved no conclusive result, apart from two variants in the UMOD gene, classified as class 3 and 4 following ACMG criteria. Method Whole exome sequencing (WES), linkage analysis, haplotype reconstruction, whole genome sequencing (WGS), long-range PCR (LR-PCR). Results The detailed pedigree of the family displayed an autosomal dominant disease with several family members reaching end-stage kidney disease on both the maternal and paternal sides. The maternal family is characterized by polycystic disease of the kidney and most profoundly the liver, with two female members already liver transplanted and one on the waiting list. The paternal family shows more unspecific chronic kidney disease (CKD) with multiple cysts in the kidney, but not in the liver. Two male members reported gout attacks, before the knowledge of CKD. We consented 12 family members for research studies and collected blood for DNA. Contemporary MPS of a virtual panel for cystic diseases (&amp;gt; 60 genes, i.e. PKD1 and PKD2, all known genes for cystic liver disease) in the index patient did not yield a conclusive result, apart from the previously reported UMOD variants [c.464G&amp;gt;A, p.(Cys155Tyr) and c.907G&amp;gt;C, p.(Asp303His)]. These variants both segregated in the paternal family, defining them as lying in cis on one allele. WES was performed on a trio of three affected family members of the maternal family, yielding no further result. Linkage analysis showed 9 peaks with a LOD score above 2.0. One peak is situated on chromosome 16, containing the candidate genes PKD1 and IFT140. WGS revealed the heterozygous variant c.2180T&amp;gt;C, p.(Leu727Pro) in exon 11 of PKD1, which has been reported as causative numerous times in the past. Conventional LR-PCR, which is designed to acknowledge the highly homologous regions of the 6 pseudogenes of PKD1, also retrieved the PKD1 variant, which was not called by MPS. Comparing the sequence reads of the WES with the WGS, the PKD1 variant was detected in 12% in the former, whereas complete detection was achieved in the latter. Since the cutoff for calling variants in WES was set to 20%, the PKD1 variant was not visible to the genetic analyst. The index patient indeed inherited both diseases from her parents, giving her the simultaneous diagnoses of ADPKD and ADTKD(-UMOD). Conclusion ADPKD is one of the most frequent genetic diseases of the human, with PKD1 being involved in &amp;gt; 80% of cases. With the apparent ease of modern technology, increasingly ADPKD families are presented for genetic consultation, also to non-specialized centers. It is tempting to use MPS considering the number of candidate genes and the size of PKD1 (46 exons). However, a negative result should be supported either by LR-PCR or WGS, taking the profound difficulties with the 6 pseudogenes of PKD1 into consideration. It is not known whether the predominance of liver disease in this family with the PKD1 c.2180T&amp;gt;C variant implicates a genotype-phenotype correlation, or whether other (genetic) modifiers may press for a liver phenotype. The renal prognosis of the index case is feared to be worse baring both diseases, even with the pathogeneses being different with a ciliopathy (ADPKD) and a toxic proteinopathy (ADTKD-UMOD), respectively. Since both affected genes are situated on the respective chromosomes 16, the patient bares a 100% risk of receiving children with an adult onset kidney disease, where pre-implantation technology will not solve this specific problem.

Knowledge Graph Construction of Chronic Kidney Disease Diagnosis and Treatment with Traditional Chinese Medicine

Background. The purpose of this study is to construct a knowledge graph of chronic kidney disease (CKD) diagnosis and treatment with traditional Chinese medicine (TCM), reorganize its knowledge, and display it. It allows the inheritance, development, and utilization of CKD diagnosis and treatment experiences with TCM in a standard and scientific manner. Methods. First, we constructed a knowledge framework for TCM diagnosis and treatment on the basis of the Chinese Pharmacopoeia, government projected textbook, and the current TCM diagnosis and treatment standards. Then, we collected and sorted the electronic medical records of TCM inpatients, extracting and normalizing the diagnoses, symptoms, syndromes, prescriptions, and other diagnosis and treatment information, creating the knowledge base of TCM diagnosis and treatment for CKD. Finally, we stored TCM diagnosis and treatment CKD knowledge in Neo4j graph database, which refers to the knowledge framework and knowledge base. The frequent patterns and complex network knowledge mining methods are integrated to construct the TCM diagnosis and treatment CKD knowledge graph. Results. The knowledge graph of CKD diagnosis and treatment with TCM was constructed, including 807 nodes and 10476 relationships, which are 273 diagnoses, 130 symptoms, 34 syndromes, 370 Chinese herbal medicine (CHM) nodes, and 5483 diagnosis-symptom, 1349 diagnosis-syndrome, 3644 syndrome-CHM relationships. Conclusion. The knowledge graph provides rich knowledge of TCM diagnosis and treatment of CKD, which is helpful to inherit the clinical experience of TCM diagnosis and treatment of CKD and assist clinical diagnosis and treatment of CKD.

FACTORS PREDICTING SELF-MANAGEMENT BEHAVIORS AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 3 IN SUPHANBURI PROVINCE, THAILAND

This research examined factors predicting self-management behaviors of patients with chronic kidney disease (CKD) stage 3 in Suphanburi Province. A multi-stage sampling technique was used to recruit participants from 10 hospitals in 10 districts of Suphanburi Province. A total of 228 participants have been diagnosed with CKD stage 3. Data were collected using a questionnaire with an overall Cronbach’s alpha coefficient of 0.96. Data were analyzed using descriptive statistics and stepwise multiple regression at the significant level of 0.05. The results showed that the social support scores from medical personnel had high levels (52.20%). Meanwhile, the score of healthcare providers, village health volunteers, and families had low levels (76.80%, 98.20%, and 85.10%, respectively). For illness perception, perceived benefits, self-efficacy, and self-management behaviors of patients with CKD stage had high levels (62.30%, 92.10%, 95.60%, and 50.90%, respectively). Meanwhile, CKD knowledge had moderate levels of 58.30%. The strongest predictor of self-management behaviors in a patient with CKD stage 3 was social support from healthcare providers (Beta = 0.348, p-value &lt; 0.001), followed by perceived benefits (Beta = 0.299, p-value &lt; 0.001) and self-efficacy (Beta = 0.266, p-value &lt; 0.001), respectively. These factors account for 42.70% of predicting self-management behaviors of a patient with CKD stage 3. In conclusion, healthcare providers should encourage the self-management behaviors of patients with stage 3 CKD by enhancing their perceived benefits and self-efficacy to modify behaviors in order to slow the progression of CKD.

Unmet Needs of CKD in Latin America: A Review from Expert Virtual Working Group

Chronic kidney disease (CKD) represents a major challenge for Latin American (LatAm) because of its epidemic proportions. Therefore, the current status and knowledge of CKD in Latin America is not clearly understood. Moreover, there is a paucity of epidemiologic studies that makes the comparison across the countries even more difficult. To address these gaps, a virtual kidney expert opinion meeting of 14 key opinion leaders from Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Ecuador, Guatemala, Mexico, and Panama was held in January 2022 to review and discuss the status of CKD in various LatAm regions. The meeting discussed the following: (i) epidemiology, diagnosis, and treatment of CKD, (ii) detection and prevention programs, (iii) clinical guidelines, (iv) state of public policies about diagnosis and management of chronic kidney disease, and (v) role of innovative therapies in the management of CKD. The expert panel emphasized that efforts should be made to implement timely detection programs and early evaluation of kidney function parameters to prevent the development or progression of CKD. Furthermore, the panel discussed the importance of raising awareness among health care professionals; disseminating knowledge to the authorities, the medical community, and the general population about the kidney and cardiovascular benefits of novel therapies; and the need for timely updating of clinical practice guidelines, regulatory policies, and protocols across the region.

Assessing Chronic Kidney Disease Knowledge, Beliefs, and Risk among Detroit Residents

ABSTRACT Background In 2020, Detroit residents’ crude kidney disease mortality rate was 1.48 times the state’s rate. Purpose Evaluated Detroit residents’ chronic kidney disease (CKD) knowledge, risk, belief, and preventative practices. Additionally, it examined the association between residents’ CKD knowledge, their sociodemographics, CKD risk and belief. Methods 378 Detroit residents, ages 20 years or older, were recruited from May 2019-August 2021 to complete the Qualtrics survey on their CKD knowledge, beliefs, and risk. Descriptive statistics and multiple linear regression were conducted to meet the study’s purpose. Results Most participants were unaware of dry and itchy skin as a CKD symptom (60%). African Americans (β = −1.5; p = .002) and those with a high school education or less (β = −1.46; p = .038) had lower knowledge scores than White residents and those with higher education. Participants’ knowledge score increased by 0.64 as CKD risk score increased by 1 (β = 0.64; p = .019). Discussion CKD knowledge is low among Detroit residents and associated with race, education, and risk level. Translation to Health Education Practice: African American Detroit residents would benefit from targeted marketing and communication plans that increase their knowledge of CKD prevention. It also depicts key components (e.g., risks factors) that should be communicated in the messages.

Knowledge, Attitudes and practices to detect and prevent Chronic Kidney Disease among hypertensive patients at primary and cardiology clinics in the Emirates of Ajman and Sharjah, UAE

The alarming association of Hypertension and Chronic Kidney Disease (CKD) has urged severalresearch to investigate the level of knowledge, attitudes and practices (KAP) of CKD among hypertensive patients,yet none was donein the United Arab Emirates (UAE). This study aimed to assess the KAP concerning CKDand their relation to the socio-demographic and clinical factors of hypertensive patients. A cross-sectional study was conducted among hypertensive patients attending cardiology and primary clinics in the Emirates of Ajman and Sharjah in the UAE. A validated face-to-face questionnairewas conductedfrom December 2019 until February 2020. The questionnaire consisted of three sections: socio-demographic characteristics, clinical characteristics and the KAP scales. Multiple linear regression was used to analyze the relation of the KAP scores to the sociodemographic and clinical characteristics.A total of 200 patients with hypertension consented to participate. The mean age was 49.97(±9.67) years. The percentages of knowledge, attitudes and practices scores about prevention and detection of CKD were 50.8%, 66.6% and 71.7% respectively.A higherknowledge score wasrelated significantly to female gender, urban residency and university level education.Cardiology clinic setting was the only significant factor related to higher attitudes score. Furthermore, higher knowledge score, higher attitudesscoreand urban residencywas significantly related tohigher practices score.Hypertensive patients require more attentionto implement CKD awareness programs that could possibly improve theirpreventive practices.

Strategies to Improve Long-Term Outcomes for Patients with Chronic Kidney Disease in China.

Chronic kidney disease (CKD) is an incurable disease requiring lifelong management. China has a high prevalence of CKD, which disproportionately affects older adults and those with chronic risk factors for CKD development. The rising prevalence of CKD in China places a substantial burden on the general population and the healthcare system. In China, there are currently many unmet needs for patients with CKD and high-risk individuals, resulting from a lack of education and support to reduce risk factors, delayed diagnoses, limited knowledge of CKD among primary-care physicians, and poor access to treatments among some patient populations. An integrated, nationwide approach is required to improve the current situation of CKD management in China. There are currently several national healthcare frameworks in place that focus on new major health policies to prevent disease and encourage people to adopt healthier lifestyles, and while they do not directly target CKD, they may have a positive indirect impact. We explore the unmet needs for patients with CKD in China and discuss the potential strategies that may be required to overcome them. Such strategies include improving physician and patient education, establishing a targeted screening programme, supporting patients to improve self-management behaviours, accelerating the creation of medical consortia and medical satellite centres, and migrating from hospital- to community-based management. In addition to policy-driven strategies, development of novel therapies will be key to providing new solutions for the long-term management of CKD. An integrated, nationwide approach is required, incorporating policy-driven changes to the clinical management of CKD, as well as the development of novel CKD treatments.

Evaluation-of-the-impact-of-clinical-pharmacists-educational-intervention-on-the-knowledge-of-patients-with-chronic-kidney-disease

Introduction: Chronic kidney disease (CKD) is a progressive disease associated with high morbidity and mortality at all stages. Objective: To determine the impact of pharmacists’ educational interventions on the CKD knowledge and knowledge levels of patients with pre-dialysis CKD, and to identify potential predictors of good CKD knowledge. Method: Two main healthcare facilities in Maiduguri, Nigeria, were the study settings for this randomised, controlled, prospective study with a 12-month follow-up. Participants were randomised to the usual care (UC) and pharmacists’ intervention (PI) groups on a 1:1 ratio. The PI group was offered usual care plus face-to-face CKD education and self-management of CKD, an educational CKD infographic leaflet, and telephonic interventions. Categorical data were compared using Chi-square or Fisher exact tests where relevant, while an independent sample T-test was used to compare the mean values of the two study groups. A p-value of less than 0.05 was considered to be statistically significant. Result: Baseline characteristics were similar between the PI (n = 73) and UC (n = 74) patients, although participants in the PI group were significantly more female (71.2% vs. 52.7%; p = 0.021). The overall mean knowledge score of the PI group was significantly higher than the UC group at 6 months (18.9 ± 3.4 vs.14.6 ± 4.4, p < 0.001), and at 12 months (19.5 ± 3.8 vs.16.8 ± 6.0, p < 0.001), respectively. At 6 months, a significant proportion of the participants in the intervention group had high knowledge compared with those in the UC group (16.4% vs. 9.0%, p < 0.001). At the end of the study, the adjusted analysis revealed that those between 40 and 64 years of age (AOR 26.3, 95% CI 2.1 – 331.0) and 65 years of age or more (AOR 10.1 95% CI 1.1 - 89.7) were more likely to have good CKD knowledge. Also, participants in the intervention group (AOR 2.7, 95% CI1.0 - 7.2) had a higher likelihood of having good CKD knowledge. Conclusion: Educational interventions provided by pharmacy students/clinical pharmacists resulted in significant improvements in the CKD knowledge of patients with pre-dialysis CKD.

The Codevelopment of "My Kidneys & Me": A Digital Self-management Program for People With Chronic Kidney Disease.

Health care self-management is important for people living with nondialysis chronic kidney disease (CKD). However, the few available resources are of variable quality. This work describes the systematic codevelopment of "My Kidneys & Me" (MK&M), a theory-driven and evidence-based digital self-management resource for people with nondialysis CKD, guided by an established process used for the successful development of the diabetes education program MyDESMOND (Diabetes Education and Self-Management for Ongoing and Newly Diagnosed, DESMOND). A multidisciplinary steering group comprising kidney health care professionals and researchers and specialists in the development of complex interventions and digital health provided expertise in the clinical and psychosocial aspects of CKD, self-management, digital health, and behavior change. A patient and public involvement group helped identify the needs and priorities of MK&M and co-design the resource. MK&M was developed in 2 sequential phases. Phase 1 involved the codevelopment process of the MK&M resource (content and materials), using Intervention Mapping (IM) as a framework. The first 4 IM steps guided the development process: needs assessment was conducted to describe the context of the intervention; intervention outcomes, performance objectives, and behavioral determinants were identified; theory- and evidence-based change methods and practical strategies to deliver change methods were selected; and program components were developed and refined. Phase 2 involved the adoption and adaptation of the existing MyDESMOND digital platform to suit the MK&M resource. The needs assessment identified that individuals with CKD have multiple differing needs and that delivering a self-management program digitally would enable accessible, tailored, and interactive information and support. The intended outcomes of MK&M were to improve and maintain effective self-management behaviors, including physical activity and lifestyle, improve knowledge, promote self-care skills, increase self-efficacy, and enhance well-being. This was achieved through the provision of content and materials designed to increase CKD knowledge and patient activation, reduce health risks, manage symptoms, and improve physical function. Theories and behavior change techniques selected include Self-Management Framework, Capability, Opportunity, Motivation Behavior model components of Behaviour Change Wheel and taxonomy of behavior change techniques, Health Action Process Approach Model, Common Sense Model, and Social Cognitive Theory. The program components developed comprised educational and behavior change sessions, health trackers (eg, monitoring blood pressure, symptoms, and exercise), goal-setting features, and forums for social support. The MyDESMOND digital platform represented an ideal existing platform to host MK&M; thus, the MyDESMOND interface and features were adopted and adapted for MK&M. Applying the IM framework enabled the systematic application of theory, empirical evidence, and practical perspectives in the codevelopment of MK&M content and materials. Adopting and adapting a preexisting platform provided a cost- and time-efficient approach for developing our digital intervention. In the next stage of work, the efficacy of MK&M in increasing patient activation will be tested in a randomized controlled trial.

Knowledge of Chronic Kidney Disease among the General Population: A Questionnaire Survey in Hokkaido Prefecture, Japan

Public education programs about chronic kidney disease (CKD) are important activities worldwide. The present study investigated the knowledge of CKD in the general population of 58 out of 179 cities or towns in Hokkaido between 1 April and 30 September 2019. A total of 15,012 respondents who underwent specific health checkups at these centers answered the questionnaire. In response to a questionnaire item asking about the respondent's familiarity with the term "CKD", only 6% of the respondents answered "know it well" and 13% answered "heard of it". In contrast, in response to a questionnaire item asking about the respondent's familiarity with "chronic kidney disease", 31% answered "know it well" and 33% answered "heard of it". The leading avenue by which the respondents learned about CKD was television, followed by newspapers, magazines, and a family doctor or nurse. The leading component that the respondents considered essential for the diagnosis of CKD was proteinuria. These results indicated that the knowledge of CKD in Hokkaido prefecture is still inadequate. Many people did not appear to realize that the term "CKD" represents "chronic kidney disease". Further continuous public education efforts are required to enlighten people about CKD.