Knowledge Of Chronic Kidney Disease Research Articles

Measuring the Awareness of Chronic Kidney Disease (CKD) with Environmental Evaluation among Adult Diabetic Patients in Hail Region, Saudi Arabia.

Introduction Chronic kidney disease (CKD) is one of the main chronic complications of T2DM that happens among T2DM patients who have uncontrolled glucose. Because CKD is considered a silent disease, the diagnosis is usually made at late stages when there will be few chances to prevent the adverse outcome. Aim The goal of this study was to assess adult diabetic patients' awareness of developing chronic kidney disease at the community level in Hail region, Saudi Arabia, in 2022. Patients and Methods. This is a cross-sectional study conducted among diabetic patients in the Hail region, Saudi Arabia. A self-administered questionnaire translated into Arabic was distributed among patients with DM. The questionnaire covers social and demographic variables (such as age, gender, relationship status, and so on) as well as a 7-item questionnaire to assess the DM population's knowledge of CKD. Results 400 DM patients responded to our survey (51% females vs 49% males). Patients who were diagnosed with type 2 diabetes were 23.8% and 40.5% had a diabetes duration of 5–15 years. Nearly half (46.8%) were considered as a poor level of awareness, 29.3% had a moderate, and 24% had a good awareness level. Factors associated with an increased level of awareness were being a bachelor's degree, being unmarried, being a student, and having a doctor as a source of CKD information. Conclusion There was a deficiency in the level of awareness among the diabetic patients in our region. Patients who were single with better education and who were well informed by the doctors about CKD information tend to be more aware of CKD as compared to other DM patients. Further research is warranted in order to establish the awareness level of DM patients regarding CKD and its complications.

The CKD Stress Scale: Development and identification of patients at risk.

Develop a novel chronic kidney disease (CKD)-specific stress scale and examine associations with patient characteristics. Adults with CKD stages 1-5 enrolled in a cross-sectional survey. Eight questions assessed patients' thoughts and feelings of stress related to CKD (CKD Stress Scale). Patients also reported their knowledge of CKD, barriers to CKD health, and demographics. The scale was evaluated using exploratory factor analysis and Cronbach's alpha. Associations were examined via linear regression. 245 participant enrolled with a mean age of 60 years and a mean estimated glomerular filtration rate (eGFR) of 34 mL/min/1.73m2; 49% were women (match percentage in Table 1), 74% White, 14% African American. A one-factor model of CKD Stress exhibited high internal consistency (α = 0.89). In bivariate analyses, higher CKD Stress was associated with lower eGFR, younger age, African American race (compared to White), and having a high school education or some college (compared to college degree or higher). Adjusting for these characteristics, as well as income and knowledge about CKD, only lower eGFR (b = -0.01; 95% CI [-0.01, -0.001]), younger age (b = -0.01; 95% CI [-0.01, -0.003]), African American race (b = 0.35, 95% CI [0.10, 0.60]), and receiving a high school education or some college (b = 0.20, 95% CI [0.01, 0.39]) were independently associated with more CKD-specific stress. Concurrent validity was supported by associations between stress and perceived barriers to care. Our CKD Stress Scale exhibits excellent internal reliability and identified where future educational interventions may benefit from tailoring for at-risk patients.

Awareness of Chronic Kidney Disease Evaluated Using Validated Questionnaire in Minia Governorate Public

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.

Knowledge of Chronic Kidney Disease Among the Population of Saudi Arabia Evaluated Using a Validated Questionnaire: A Cross-Sectional Study.

IntroductionPublic knowledge and awareness regarding chronic kidney disease (CKD) is an important factor influencing the successful implementation of CKD prevention and screening programs. To the best of our knowledge, there are no studies conducted among the Saudi population to explore the public knowledge of CKD using a validated questionnaire. Hence, we explored the knowledge of CKD among the population of the Kingdom of Saudi using a validated questionnaire to determine the level of knowledge regarding CKD as well as the predictors of CKD knowledge.Materials and MethodsThis was a cross-sectional online survey study conducted between 12 January 2020 and 11 February 2021. A structured study questionnaire in the GoogleTM platform, with socio-demographic variables and questions assessing CKD knowledge, was used to collect data. A snowball sampling technique was used to recruit participants.ResultsA total of 983 people accessed the survey and 951 provided a complete response. Respondents belonging to the age group 41–55 years, having masters or PhD level education, having monthly income >15,000 SR, married, doing >150 minutes/week physical activity had significantly higher kidney disease knowledge. There were significant differences in the mean kidney disease knowledge total score between participants with and without: a history of kidney disease (5.63, df = 895, p<0.001), diabetes mellitus (2.34, df = 949, p = 0.019), hypertension (3.25, df = 949, p = 0.001), and family history of kidney failure (4.60, df = 949, p<0.001).ConclusionThe study revealed a lack of awareness among the Saudi population regarding knowledge about CKD. However, a significantly higher level of knowledge prevailed among respondents from higher educational and higher economic backgrounds. Those with risk factors for CKD also held a greater knowledge about the disease.

63-OR: Focused Educational Screening Improves Knowledge of Diabetes as a Leading Risk Factor for Chronic Kidney Disease

Background: Diabetes is the leading cause of chronic kidney disease (CKD) and a major risk factor in the progression of kidney failure or end-stage kidney disease. An estimated 34.2 million Americans have diabetes, and 1 in 3 adults with diabetes may have CKD, many of whom do not know they have it. Interventions to increase CKD awareness and its complications may help promote early testing and identification among adults with diabetes. The American Kidney Fund (AKF) developed a 5-minute CKD education session and focused this intervention in the District of Columbia-Maryland-Virginia (DMV) metropolitan area. Methods­: In 2020, AKF administered a 5-item questionnaire at two AKF kidney disease screening events to assess CKD knowledge before and after 5-minute CKD education sessions. Individuals demonstrating CKD risk factors, including self-reported history of diabetes or elevated blood sugar level results, attended the education sessions. We compared responses from 129 participants and performed a paired samples t-test to determine the education sessions’ effectiveness in improving CKD knowledge. Results: The average pre-post scores increased from 57% to 89% (t(128)=10.65, p&amp;lt;0.001), with the largest gains in understanding the definition of CKD (11% to 86%, t(128)=17.62, p&amp;lt;0.001). There was a significant difference in pre-post scores for identifying diabetes and high blood pressure as the top risk factors for CKD (49% to 86%, t(128)=6.62, p&amp;lt;0.001). For the best ways to prevent CKD, keeping a healthy blood sugar level and healthy blood pressure level was also significant (65% to 89%, t(128)=4.91, p&amp;lt;0.001). Conclusion: Our study demonstrated low awareness of CKD risk factors. Educational sessions are effective for improving CKD knowledge and increasing awareness about diabetes as a major risk factor. Our study supports the expansion of CKD-related educational programs for populations at high risk for CKD. Disclosure L. Vo: None. M. Paris: None. M. Alawode: None. M. Spigler: None.

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

Introduction: Chronic kidney failure in India and around the world is a significant health problem. The most effective and affordable treatment may require screening for early detection,intervention and prevention. Public awareness is a key determinant to overcome the burden of Chronic Kidney Disease(CKD). However, there is a lack of information on CKD among South Indian people. Aim: To assess the awareness and knowledge of CKD among the South Indian population. Materials and Methods: A questionnaire-based cross-sectional study was conducted through an online form; the questions were generally based on the physiological role of kidney and awareness questions related to CKD. The sample size was 500 participants, of age &gt;18 years and snowball sampling method was implemented. Among the study population, 68 participants had a family history of CKD and they were excluded. The data were analysed through Pearson Chi-Square test. Results: The mean knowledge score was 13 (SD±5.0), with values ranging from 0 to 22. The mean age of the population was 47.80±8.5 years. Multiple regression on demographic data and knowledge yielded statistically negligible results.The study population included 432 participants and the result showed the realms that most responded incorrectly were physiology of kidney, CKD symptoms, risk factors and the domain of testing and diagnosis. Conclusion: The participants had ample knowledge of the risk factors, signs and symptoms of CKD and insufficient knowledge of the physiological function of the kidney and the diagnosis of CKD. Therefore, efforts are necessary to create awareness and educate people about the early detection and prevention of CKD.

Risk factors and knowledge assessment of general public for chronic kidney disease in Taif Region, Saudi Arabia

Introduction: Chronic kidney disease (CKD) is a worldwide public health problem since the rapid increasing prevalence of relevant risk factors, like diabetes, hypertension, unhealthy diet, low to no physical activity and metabolic syndrome. The current study aimed at assessing the risk factors and the general public awareness of CKD in Taif region, Saudi Arabia. Method: We conducted a cross-sectional study during the period of September 2019 to March 2020. For risk factors assessment data regarding CKD cases were collected from the department of nephrology at AL-Hada Military hospital in Taif. An online-based questionnaire was distributed to the general public for knowledge assessment of CKD. 6th year pharmacy student at Taif University and nephrologists from the hospital were also invited to answer the questionnaire. Results: The data of 456 CKD patients with 600 non-CKD individuals were compared for assessment of the most common risk factors. 99% of participants were CKD stage III-V patients. The majority, n=371(81.57%), of the participants were &gt;50 years old. N=328(71.93%) had type 2 diabetes mellitus (Risk ratio= 2.32, CI= 2.03-2.65; Odd ratio=5.7, CI= 4.36-7.45), n=396(86.84%) had hypertension (Risk ratio =9.65,CI-7.46-12.48; Odd ratio: 66.73, CI=45.19-98.54) and n=264(57.89%) had a history of heart diseases (Risk ratio= 3.62, CI=2.96-4.42; Odd ratio= 7.22, CI= 5.42-9.62). In CKD groups, 28.07% of them had low physical activity. In contrast with the control group, only 4% had low physical activity level in their daily routine (p&lt;0.00001). In the general public (n=1419), 919 (64.7%) had poor knowledge, 273 (19.22%) had fair knowledge, and 227 respondents (16.01%) had good knowledge of CKD. Conclusion: The finding suggests that age &gt;50 years, low educational attainment, family history of CKD, diabetes, hypertension, history of kidney stone, CVD and high BMI were significantly associated with CKD progression. We also found that the majority of the general public had poor knowledge of CKD compared to pharmacy graduates and nephrologists. These findings warrant the need for the development of awareness initiatives and programs designed to increase the level of knowledge of the general public of CKD.

Kidney Disease Knowledge and Its Determinants Among Patients With Chronic Kidney Disease.

The alarming rise in the incidence of end-stage renal disease in Nigeria is likely to continue if patients with chronic kidney disease (CKD) lack knowledge of this disease, its management, and practices to support effective self-management. The study aimed to assess CKD knowledge and to investigate its predictors. A cross-sectional survey was conducted using a paper-based questionnaire at the medical and nephrology outpatients' clinics of a secondary and tertiary hospital in Maiduguri. The study enrolled 220 patients with CKD stages 1 to 4. Sixty-five percent of the participants had poor CKD knowledge. The patients who had a tertiary level of education were significantly more likely to have higher CKD knowledge compared to those with no formal education (adjusted odds ratio: 2.62, 95% CI: 1.20-5.72). The study shows that the majority of the participants had poor CKD knowledge. Tertiary educational level was the only significant independent predictor of higher CKD knowledge. Therefore, targeted educational interventions are needed among patients with no or low formal education to be able to support them with self-management behaviors.

Perceived barriers and facilitators to chronic kidney disease care among patients in Singapore: a qualitative study

ObjectiveTo outline the facilitators and barriers to patients’ self-management of predialysis chronic kidney disease (CKD).DesignQualitative.SettingThree polyclinics in a public primary care institution in Singapore.Participants20 patients entered and completed the study....

Knowledge Does Not Correspond to Adherence of Renal Diet Restrictions in Patients With Chronic Kidney Disease Stage 3-5

Nutrition plays a critical role in delaying the progression of chronic kidney disease (CKD); however, adherence to nutrition recommendation in patients with non-dialysis-dependent CKD (NDD-CKD) has been underexplored. The objective of this research is to determine patients with NDD-CKD adherence to nutrition recommendation, and whether knowledge of dietary recommendations impacts adherence. Patients with NDD-CKD and a glomerular filtration rate <45mL/min were recruited from an urban, outpatient nephrology clinic. To assess adherence, patients completed an online Food Frequency Questionnaire. Knowledge of renal diet restrictions and food sources of sodium, potassium, and phosphorus was assessed by a CKD Knowledge Questionnaire. A total of 63 patients completed both the Food Frequency Questionnaire and CKD Knowledge Questionnaire. Patients were consuming excess protein (average intake of 1.16g/kg; 65-81% of patients' intake above goal), sodium (average intake of 3,117mg, 67-91% of patients' intake above goal), and phosphorus (average intake of 1,153mg, 59-70% of patients' intake above goal). In patients without hyperkalemia, only 32-43% of patients consumed adequate potassium. People with hyperkalemia did not consume less potassium than those without hyperkalemia (2,327 vs. 2,564mg, P=.36). Awareness of diet restriction was not associated with reduced intake of phosphorus (785 vs. 907mg, P=.21), protein (54.4 vs. 57.0g, P=.71), or potassium (1,793 vs. 2,076mg, P=.27). Greater knowledge of nutrient food sources did not correlate to reduced intake of sodium (r=-0.078, P=.54) or phosphorus (r=-0.053, P=.68), or potassium in people with hyperkalemia (r=0.025, P=.92). Patients with NDD-CKD consume excess sodium, phosphorus, and protein, whereas potassium intake is inadequate in people without hyperkalemia. Greater knowledge of the renal diet was not associated with increased adherence to dietary restrictions. Instruction efforts should go beyond providing nutrient-based diet information, and instead emphasize healthy food patterns and incorporate counseling to promote behavior change.

Talk Shows and Leaflets Improve Senior High School Student Knowledge of Chronic Kidney Diseases

Background: The increase of chronic kidney disease (CKD) incidence and its related costs in developing countries have urged all levels of society prevent this disease. Prevention can be effectively done when someone has good knowledge about the disease. This study aimed to observe the change in knowledge about CKD before and after education sessions in the form of talk shows as well as through the leaflet media among senior high school students. Methods: This was a cross-sectional observational quantitative study on 71 first-grade students participated in World Kidney Day 2019 event. The questionnaire was distributed before and after the education program and data collected were analyzed using the Wilcoxon-signed rank test and Mann-Whitney test to explore changes in the level of knowledge based on the characteristics of the subjects. Results: The median level of student knowledge before education was 76% (16-96%), which increased to 92% (28-100%) after education (p&lt;0.001). No significant correlation was observed between knowledge about CKD and gender (p=0.486), family history of CKD (p=0.281), and health workers as parents (p=0.543). Conclusion: There is a significant improvement in knowledge of CKD before and after an education session through talk shows and leaflets among senior high school students. Health educations need to be regularly given to young adolescents using different approaches to increase their knowledge about various topics.

P0814NEW STRATEGIES TO DECREASE THE ANNUAL RATE OF DIALYSIS INITIATIONS AT A HOSPITAL IN CENTRAL TOKYO

Abstract Background and Aims The Japanese Government and the Japanese Society of Nephrology (JSN) have enacted measures against chronic kidney disease (CKD) since 2008. Since then, the number of age-adjusted dialysis initiations has decreased. However, the absolute number has not decreased due to aging of the population. In response, the Japanese Government launched new CKD measures in 2018, with a focus on earlier intervention by nephrologists, utilizing referral criteria from family doctors to nephrologists. The primary goal of the new measures is to decrease the annual number of dialysis initiations nationwide by 10% by 2028. The Japan Kidney Association (JKA), also established in 2018, has appointed representatives in each prefecture to work on CKD measures according to the local requirements in cooperation with the Government, family doctors, and organizations. The large number of family doctors and medical examinations facilities that refer to the hospital in central Tokyo lead to difficulty determining the referral criteria that is used. Therefore, the aim of this study is to formulate new CKD measures in our hospital as one of the JKA representatives of Tokyo. Method A retrospective survey of medical history was conducted for 104 patients who initiated hemodialysis or peritoneal dialysis at our hospital in 2018. These patients represent approximately 3% of the total number of dialysis initiations in Tokyo, with 33 patients originating from outside Tokyo prefecture. Of the 104 patients, 80 were male with an average age 65.9 years. The primary disease of patients was comprised of 30 with diabetic nephropathy, 25 with renal sclerosis, 16 with chronic glomerulonephritis, 4 with polycystic kidney disease, and 29 from other or unknown diseases. Results Of the 86 patients whose information was confirmed, 45 patients were referred to nephrologists from 15 departments in our hospital, including 12 from diabetic departments, 7 from urology departments, 4 from cardiovascular departments, 3 from the emergency department, oncology department, and neurology department, and 11 from various other departments. The remaining 41 patients were from outside our hospital (30 from family doctors and 11 from medical examination facilities). Of the 57 patients whose eGFR was confirmed at referral, 21 were referred with eGFR&amp;lt;15, 27 at 15≦eGFR&amp;lt;30, and only 9 were referred at eGFR≧30. Criteria of eGFR&amp;lt;45 or proteinuria≧1+ or 0.5g/gCr is recommended in the 2018 Evidence-based Clinical Practice Guideline for CKD by the JSN. Conclusion According to the medical history of 104 patients who initiated dialysis at our hospital in 2018, the timing of referral to nephrologists was often later than recommended. Patients were referred to nephrologists from at least 15 departments in our hospital. Therefore, it is important for the referral criteria to be widely disseminated not only among family doctors but also among hospital departments and medical examination facilities. Specifically, in-hospital referrals are considered to be less burdensome for patients than out-of-hospital referrals and are therefore expected to be first-targets for new strategies. In addition, in recent years, the frequency of measurement of sCr and eGFR has increased in medical examinations, where the dissemination of referral criteria becomes even more important. Furthermore, the JSN and the JKA have committed to develop medical staff, including nurses/public health nurses, registered dietitians, and pharmacists, to be certified kidney disease educators who have basic knowledge of CKD. Since these occupations can intervene before referral to nephrologists, they are expected to have a significant effect on CKD measures.

A Virtual Multidisciplinary Care Program for Management of Advanced Chronic Kidney Disease: Matched Cohort Study.

BackgroundIt is not well established whether a virtual multidisciplinary care program for persons with advanced chronic kidney disease (CKD) can improve their knowledge about their disease, increase their interest in home dialysis therapies, and result in more planned outpatient (versus inpatient) dialysis starts.ObjectiveWe aimed to evaluate the feasibility and preliminary associations of program participation with disease knowledge, home dialysis modality preference, and outpatient dialysis initiation among persons with advanced CKD in a community-based nephrology practice.MethodsIn a matched prospective cohort, we enrolled adults aged 18 to 85 years with at least two estimated glomerular filtration rates (eGFRs) of less than 30 mL/min/1.73 m2 into the Cricket Health program and compared them with controls receiving care at the same clinic, matched on age, gender, eGFR, and presence of heart failure and diabetes. The intervention included online education materials, a virtual multidisciplinary team (nurse, pharmacist, social worker, dietician), and patient mentors. Prespecified follow-up time was nine months with extended follow-up to allow adequate time to determine the dialysis start setting. CKD knowledge and dialysis modality choice were evaluated in a pre-post survey among intervention participants.ResultsThirty-seven participants were matched to 61 controls by age (mean 67.2, SD 10.4 versus mean 68.8, SD 9.5), prevalence of diabetes (54%, 20/37 versus 57%, 35/61), congestive heart failure (22%, 8/37 versus 25%, 15/61), and baseline eGFR (mean 19, SD 6 versus mean 21, SD 5 mL/min/1.73 m2), respectively. At nine-month follow-up, five patients in each group started dialysis (P=.62). Among program participants, 80% (4/5) started dialysis as an outpatient compared with 20% (1/5) of controls (OR 6.28, 95% CI 0.69-57.22). In extended follow-up (median 15.7, range 11.7 to 18.1 months), 19 of 98 patients started dialysis; 80% (8/10) of the intervention group patients started dialysis in the outpatient setting versus 22% (2/9) of control patients (hazard ratio 6.89, 95% CI 1.46-32.66). Compared to before participation, patients who completed the program had higher disease knowledge levels (mean 52%, SD 29% versus mean 94%, SD 14% of questions correct on knowledge-based survey, P<.001) and were more likely to choose a home modality as their first dialysis choice (36%, 7/22 versus 68%, 15/22, P=.047) after program completion.ConclusionsThe Cricket Health program can improve patient knowledge about CKD and increase interest in home dialysis modalities, and may increase the proportion of dialysis starts in the outpatient setting.

Access to CKD Care in Rural Communities of India: a qualitative study exploring the barriers and potential facilitators

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.

The Effects of Self-Management Interventions on the Health Outcomes of Individuals With Chronic Kidney Disease After Critical Illness: An Integrative Review

BackgroundSelf-management is a crucial step towards achieving better physical and mental well-being and a better health-related quality of life for individuals with chronic kidney disease (CKD). Despite the high prevalence of CKD and the significant burdens faced by the individuals with CKD, their caregivers, and healthcare systems, very few studies have explored CKD and its consequences compared to other chronic diseases.ObjectiveTo synthesize and present the best available evidence on the effectiveness of CKD self-management interventions in terms of the biomedical, psychosocial, and behavioral aspects of health outcomes.MethodsThree electronic English-language literature databases were searched from inceptions to March 2018. Two reviewers independently selected articles according to pre-specified criteria, critically appraised and extracted data from relevant research. Narrative summaries were presented because the interventions and study features of the included articles were heterogeneous.ResultsOf the five included articles, three were interventional and two were systematic reviews. Effective self-management interventions have beneficial effects on biomedical outcomes such as blood pressure, psychosocial outcomes such as quality of life and self-efficacy, and behavioral outcomes such as CKD knowledge, self-management techniques, and adherence to self-care regimens and treatments.ConclusionsA self-management program that could provide better education and guidance for individuals with CKD is needed, as this would improve the provision of resources and preparations for foreseeable and avoidable CKD complications. The findings from the included articles demonstrate that limited amount of research has focused on CKD management. Additional randomized controlled trials that compare interventions with usual care are needed to determine the efficacy of CKD self-management programs.

Survey on knowledge, attitude and behavior in patients with chronic kidney disease

Objective To investigate the knowledge, attitude, and behavior of patients with chronic kidney disease (CKD) in the community. Methods A questionnaire survey on knowledge, attitude and behavior through the mobile WeChat was conducted among 1 006 CKD patients in 57 villages of Jinze and Huaxin communities in Shanghai Qingpu district from June 2016 to May 2018, and the results were analyzed. Results The accuracy rate about CKD knowledge in 1 006 CKD patients was 69.98%. The participants who were very willing to accept referral, learning CKD knowledge, periodic follow-up, health education and lifestyle counseling accounted for 60.40%, those who were willing accounted for 32.59% and not willing for 7.01%. The survey of behavioral patterns showed that 29.17% often participated in actively learning disease knowledge, periodic follow-up and counseling, reasonable diet and regular exercise; 52.96% occasionally participated and 17.87% never participated. There were no significant differences in knowledge about CKD among patients of different sex, age and occupation(t=0.475,F=7.111,F=0.563;all P>0.05); while the CKD knowledge level was higher in patients with college or above educational levels (7.80±3.96) , or patients with a disease history over 5 years (7.64±2.84) , or patients with stage 5 CKD (8.25±1.16) . Conclusion The rate of knowledge, attitude and behavior in CKD patients is relatively low, especially in attitude and behavior. In order to control the disease progression and reduce the adverse impact of the disease, it is necessary to take effective measures to improve the attitude and behavior of CKD patients. Key words: Chronic kidney disease; Knowledge; Attitudes; Behaviors; Combination of medical and medical care

Novel educational and goal-setting tool to improve knowledge of chronic kidney disease among liver transplant recipients: A pilot study.

IntroductionLiver transplant (LT) recipients have limited understanding of post-transplant chronic kidney disease (CKD) despite an excellent pre-existing framework of transplant care. This pilot study examined the efficacy and feasibility of a tailored educational and goal-setting tool in improving CKD knowledge among LT recipients with early-stage CKD.MethodsIn this prospective cohort study, we administered the CKD educational and goal-setting tool to 81 LT recipients between 7/1/2016 and 12/31/2017. We excluded patients with simultaneous liver-kidney transplantation, eGFR<30 ml/min, non-English speaking, on hemodialysis or listed for kidney transplantation. The pre- and post-education knowledge scores were compared using a paired t-test. Linear regression was used to assess the independent predictors of change in knowledge score.ResultsMean age was 56.3 years, 69.1% were males, 85.2% were Caucasians and mean eGFR was 61.2 ± 20.0 ml/min. The CKD educational and goal-setting tool improved the CKD knowledge scores among LT recipients (pre: 71.8 ± 16.6%, post: 83.3 ± 10.4%; p<0.001). In an adjusted model (r2 = 0.75), those with lower pre-education knowledge scores had the most improvement in their post-education knowledge scores (β = -83.2; p<0.001). Two-thirds stated their most important self-management goal and reported motivation to follow this goal. Time spent for the CKD education was approximately 15 minutes.ConclusionsA simple LT-specific patient educational and goal-setting tool effectively improved CKD knowledge. Implementation of this tailored intervention will improve CKD awareness and may promote goal-setting in the target population.

A Patient Decision Support Tool for Hepatitis C Virus and CKD Treatment

Rationale & ObjectivePatient education and decision support tools could facilitate decisions around the timing of antiviral therapy in patients living with both hepatitis C virus (HCV) infection and chronic kidney disease (CKD). We previously developed a tool through the HELP (Helping Empower Liver and Kidney Patients) study. This article evaluates the preliminary efficacy and usability of the tool among participants with both HCV infection and CKD.Study DesignPre-post study pilot evaluation.Setting & ParticipantsParticipants were at least 18 years old, were English speaking, and had a diagnosis of chronic HCV infection and CKD; they were seen in CKD clinics, dialysis units, and/or hepatology and liver transplantation clinics.InterventionElectronic patient decision support tool.OutcomesParticipants’ change in knowledge, certainty about choice, decision self-efficacy, patients’ treatment preferences, and tool usability.Results70 participants were recruited; 56 of 70 (80.0%) completed study procedures. Nearly all (51/56; 91.1%) requested paper-based study procedures despite the electronic design of the tool. Participants reported that they were most worried about the following treatment factors: (1) cost of drugs to treat HCV infection, (2) how their HCV infection affected their CKD, and (3) wait times for a kidney transplant. After using the decision tool, participants had significantly higher HCV infection and CKD knowledge (mean posttest percent of questions answered correctly = 65.74% vs pretest percent of questions answered correctly = 53.44%; P < 0.001) and more certainty about choice (mean posttest = 3.13 vs pretest = 2.65; P = 0.05). There were no significant changes in decision self-efficacy (mean posttest = 86.62 vs pretest = 84.68; P = 0.48).LimitationsSingle-site pilot study to explore preliminary tool efficacy and usability.ConclusionsThis study suggests that a decision tool may support informed patient-centered choices among patients with HCV infection and CKD. Future studies should evaluate ways to improve care decisions in a larger sample using both paper-based and electronic materials.FundingMerck & Co, Inc, Kenilworth, NJ.Trial RegistrationRegistered at clinicaltrials.gov with study number NCT03426787.

Knowledge, Self-Efficacy, Self-Management Behavior of the Patients With Predialysis Chronic Kidney Disease

Background: Chronic kidney disease (CKD) is an emerging global public health problem. Control of risk factors and prevention of complications can delay the progression to end-stage renal disease. Self-efficacy and self-management behavior in patients with predialysis CKD has not been investigated in Nepal.&#x0D; Objectives: To describe knowledge of CKD, self-efficacy, and self-management behavior in patients with predialysis CKD and to determine the relationships between knowledge in CKD and self-efficacy with self-management behavior.&#x0D; Methods: Ninety-seven predialysis CKD patients visiting nephrology clinic of a tertiary care hospital in Kathmandu, Nepal were recruited from November 2016 to December 2016. Questionnaires comprised of sociodemographic data, CKD knowledge, self-efficacy, and self-management behavior questionnaires were used. Data were analyzed, using descriptive statistics and Pearson product moment correlation coefficient.&#x0D; Results: The mean age of 97 participants was 45.67 years. There were 3 stages of CKD among participants: stage G4 (54.64%), stage G3 (42.27%), and stage G2 (3.09%), respectively. Hypertension was the most common comorbidity (81.44%) followed by diabetes mellitus (30.92%). Predialysis CKD patients had a moderate level of knowledge on CKD and self-efficacy and high level of self-management behavior. There were positive relationships between knowledge in CKD and self-management behavior (r = 0.52; P &lt; .05), and between self-efficacy and self-management behavior (r = 0.39; P &lt; .05).&#x0D; Conclusions: This study suggested that education, counseling, workshop to increase the knowledge, self-efficacy, and self-management behavior might be helpful for the predialysis CKD patients. Healthcare providers can educate, motivate, and train the patients to practice self-management behavior to delay the progression of CKD.

Conocimiento sobre la enfermedad renal crónica en la población universitaria de Málaga

Introducción: El debut de la Enfermedad Renal Crónica (ERC) se ha relacionado en parte con los escasos conocimientos de los pacientes acerca de la fisiopatología renal y los factores de riesgo relacionados, lo que a su vez predice un peor diagnóstico y pronóstico. En este sentido, una correcta alfabetización en salud desde edades tempranas puede prevenir el desarrollo de hábitos de vida perniciosos. Objetivo principal: Evaluar los conocimientos de la población universitaria de Málaga sobre los conceptos básicos asociados a la ERC. Material y Método: Se llevó a cabo un estudio transversal-descriptivo con estudiantes de Grado en la Universidad de Málaga durante el curso 2016-2017, a través de un cuestionario autoadministrado elaborado Ad Hoc para determinar sus conocimientos sobre fisiopatología renal y su prevención. El cuestionario constó de 28 preguntas, divididas en 5 categorías temáticas y fue revisado previa administración, por 10 expertos en nefrología (médicos y enfermeras) y pilotado con 38 personas. Resultados: El nivel de conocimientos resultó ser bajo en general, con 14,3±4,7 respuestas correctas de 28. Se encontraron diferencias estadísticamente significativas según rama de conocimiento, donde los estudiantes de Ciencias de la Salud obtuvieron los mejores resultados con 18,25 (IC 17,18-19,32) respuestas correctas (p&lt;0,001). Además, los estudiantes de la rama de Ciencias obtuvieron resultados equiparables a los de Ciencias de la Salud en preguntas sobre la anatomofisiología del riñón. Discusión y Conclusiones: La población universitaria de Málaga posee un bajo nivel de conocimientos acerca de la ERC. Se necesitan futuros estudios con población sana en este campo.