Dataset Information

CKD Awareness in the General Population: Performance of CKD-Specific Questions.

ABSTRACT: Rationale & Objective:Data from patients in one delivery system have suggested that the prevalence of chronic kidney disease (CKD) awareness differs by how the question is asked. We examined the sensitivity and specificity of different CKD awareness questions among diverse community-dwelling adults who were not necessarily engaged in primary care to determine the generalizability of prior results. Study Design:Cross-sectional study. Setting & Participants:Participants in the Healthy Aging in Neighborhoods of Diversity Across the Life Span (HANDLS) Study. Predictor:CKD awareness, ascertained using 5 different questions. Outcome:Sensitivity and specificity of each awareness question, using laboratory results as the gold standard. Analytic Approach:Logistic regression was used to compare sensitivities of different awareness questions. Results:Among 2,046 participants, mean (SD) age was 56.5 (9.1) years, 41.5% were men, and 61.3% were African American. More than 40% were poor, 35% reported not having health insurance, and 16.9% had low health literacy. More than 20% (n = 424) had CKD. Sensitivities of single CKD awareness questions ranged from 2.2% for "kidney damage" to 5.2% for "kidney problem." Sensitivity of the compound question asking about "weak kidneys, failing kidneys, or kidney disease" was 19.5%. Sensitivity of this compound CKD awareness question was higher among study participants with more advanced CKD and low health literacy, and those who lived below the poverty level. Limitations:Single measures of estimated glomerular filtration rate and albuminuria; study participants may have been more engaged in their health care than the average US adult, potentially limiting the generalizability of results. Conclusions:CKD awareness is low among community-dwelling adults with kidney disease, though data using a sensitive compound question ascertaining awareness suggest that we have met the Healthy People 2020 goal related to CKD awareness of 13.4%. Understanding the phrases about kidney disease that are most understandable to patients with and at risk for CKD is important to further increase CKD awareness.

SUBMITTER: Tuot DS

PROVIDER: S-EPMC7380399 | biostudies-literature | 2019 Mar-Apr

REPOSITORIES: biostudies-literature

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CKD Awareness in the General Population: Performance of CKD-Specific Questions.

Tuot Delphine S DS Wong Karen K KK Velasquez Alexandra A Crews Deidra C DC Zonderman Alan B AB Evans Michele K MK Powe Neil R NR

Kidney medicine 20190225 2

<h4>Rationale & objective</h4>Data from patients in one delivery system have suggested that the prevalence of chronic kidney disease (CKD) awareness differs by how the question is asked. We examined the sensitivity and specificity of different CKD awareness questions among diverse community-dwelling adults who were not necessarily engaged in primary care to determine the generalizability of prior results.<h4>Study design</h4>Cross-sectional study.<h4>Setting & participants</h4>Participants in th ...[more]

PMID: 32734184

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Project description:BACKGROUND:Recent genome-wide association studies have identified multiple genetic loci that increase the risk of chronic kidney disease (CKD) in the general population. We hypothesized that knowledge of these loci might permit improved CKD risk prediction beyond that provided by traditional phenotypic risk factors. STUDY DESIGN:Observational cohort study. SETTING & PARTICIPANTS:Participants who attended the 15th (1977-1979) and 24th (1995-1998) examination cycles of the original cohort or the 6th (1995-1998) and 8th cycles (2005-2008) of the offspring cohort of the Framingham Heart Study (n = 2,489). PREDICTORS:Single-nucleotide polymorphisms at 16 stage 3 CKD loci were genotyped and used to construct a genetic risk score. Standard clinical predictors of incident stage 3 CKD also were used. OUTCOMES & MEASUREMENTS:Incident stage 3 CKD was defined as estimated glomerular filtration rate <60 mL/min/1.73 m(2) at follow-up. Participants with baseline stage 3 CKD were excluded. Logistic regression was used to generate C statistics, which measured the power of the genetic risk score to discriminate risk of incident CKD stage 3 with and without traditional risk factors. RESULTS:There were 270 new stage 3 CKD cases during an average of 10.8 years of follow-up. Mean genetic risk score was 17.5 ± 2.8 (SD) for those who developed stage 3 CKD and 17.3 ± 2.6 for those who did not (P for genotype score difference = 0.2). The OR for stage 3 CKD was 1.06 (95% CI, 1.01-1.11; P = 0.03) per additional risk allele, adjusting for age and sex. In the age- and sex-adjusted model, the C statistic was 0.748 without the genotype score and 0.751 with the score (P difference = 0.3). The risk score was not statistically significant in a multivariable model adjusted for standard stage 3 CKD risk factors (P = 0.07). LIMITATIONS:All participants were of European ancestry; the genotype score may not be valid in different ancestral groups. CONCLUSIONS:A genetic score generated from 16 known CKD risk alleles did not predict new cases of stage 3 CKD in the community beyond knowledge of common clinical risk factors alone.

Project description:Rationale & objectivePatient awareness of disease is the first step toward effective management and disease control. Awareness of chronic kidney disease (CKD) has consistently been shown to be low, but studies estimating patient awareness of CKD have used different methods. We sought to determine whether the estimated prevalence of CKD awareness differed by the wording used to ascertain awareness or by setting characteristics.Study designSystematic review and meta-analysis.Setting & study populationsAdults with CKD not receiving dialysis.Selection criteria for studiesWe included studies that estimated CKD awareness, determined CKD status by laboratory criteria, and provided the exact question wording used to ascertain awareness.Data extraction2 reviewers independently extracted data for each study; discordance was resolved by a third independent reviewer.Analytical approachMixed-effects models were used to calculate pooled CKD awareness estimates and 95% CIs.Results32 studies were included. Publication year ranged from 2004 to 2017, with study populations ranging from 107 to 28,923 individuals. CKD awareness in individual studies ranged from 0.9% to 94.0%. Pooled CKD awareness was 19.2% (95% CI, 10.0%-33.6%) overall and was 26.5% (95% CI, 11.9%-48.9%) among individuals with an estimated glomerular filtration rate < 60 mL/min/1.73 m2. "Kidney problem" was the most sensitive question for CKD awareness (58.7%; 95% CI, 32.4%-80.8%); "weak or failing kidneys" was the least sensitive (12.3%; 95% CI, 4.5%-29.4%). CKD awareness was highest among patients from nephrology practices (86.2%; 95% CI, 74.9%-93.0%) and lowest in the general population (7.3%; 95% CI, 5.0%-10.5%).LimitationsSignificant heterogeneity across studies overall and among examined subgroups of wording and study setting.ConclusionsDifferently worded questions may lead to widely different estimates of CKD awareness. Consistent terminology is likely needed to most effectively surveil and leverage CKD awareness to improve management and disease control.

Dataset Information

CKD Awareness in the General Population: Performance of CKD-Specific Questions.

Publications

CKD Awareness in the General Population: Performance of CKD-Specific Questions.

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