title: Awareness of kidney disease in the US population: findings from the National Health and Nutrition Examination Survey (NHANES) 1999 to 2000.
abstract: BACKGROUND
  The prevalence of end-stage renal disease (ESRD) in the US population has been predicted to increase by 48% during the next decade and will pose a significant health cost burden. Early identification and treatment of chronic kidney disease (CKD) is necessary to delay progression from CKD to ESRD. CKD awareness among patients is crucial to early intervention programs, but its prevalence and characteristics in the noninstitutionalized US population are unknown.
  
  
  METHODS
  The National Health and Nutrition Examination Survey 1999 to 2000 was used to determine prevalence estimates of kidney disease awareness, as well as demographics, health care access, and comorbid characteristics, of participants with CKD.
  
  
  RESULTS
  In participants with CKD, 40.5% of patients with stage 1, 29.3% of patients with stage 2, 22.0% of patients with stage 3, and 44.5% of patients with stage 4 CKD were aware of their kidney disease, respectively. The aware and unaware groups did not differ by health care access. In multivariate regression modeling, lack of awareness was significantly associated with sex, race-ethnicity distribution, and hypertension.
  
  
  CONCLUSIONS
  Kidney disease awareness is low among a representative sample of the noninstitutionalized US population. Groups at greater risk for kidney disease, such as non-Hispanic blacks, patients with hypertension, and men, were more likely to be unaware of having kidney disease, even with health care access similar to that of the aware group. Increased efforts to promote kidney disease awareness are needed and probably should target primary care providers involved in the screening process.
authors.affiliation: Columbia University College of Physicians and Surgeons, New York, NY, USA. tln2001@columbia.edu
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Nickolas
authors.forename: Gershon D
authors.initials: GD
authors.lastname: Frisch
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Opotowsky
authors.forename: Raymond
authors.initials: R
authors.lastname: Arons
authors.forename: Jai
authors.initials: J
authors.lastname: Radhakrishnan
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001364:Awareness; D002908:Chronic Disease; D015331:Cohort Studies; D003144:Communication Barriers; D015897:Comorbidity; D005006:Ethnicity; D005260:Female; D006266:Health Education; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007674:Kidney Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D007677:Kidney Function Tests; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D008952:Mobile Health Units; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology