Patient awareness of chronic kidney disease: trends and predictors.
BACKGROUND
The impact of recent guidelines for early detection and prevention of chronic kidney disease (CKD) on patient awareness of disease and factors that might be associated with awareness have not been well described.


METHODS
Awareness rates were assessed in 2992 adults (age, > or =20 years) with CKD stages 1 to 4 from a nationally representative, cross-sectional survey (National Health and Nutrition Examination Survey 1999-2004). Awareness of CKD was defined by an answer of yes to "Have you ever been told you have weak or failing kidneys?" Potential predictors of awareness included demographics, access to care, and clinical and lifestyle factors, which were assessed by standardized interviewer-administered questionnaires and physical examinations. We examined independent associations of patient characteristics with awareness in those with CKD stage 3 (n = 1314) over 6 years using multivariable logistic regression.


RESULTS
Awareness improved over time in those with CKD stage 3 only (4.7% [95% confidence interval {CI}, 2.6%-8.5%], 8.9% [95% CI, 7.1%-11.2%], and 9.2% [95% CI, 6.1%-13.8%] for 1999-2000, 2001-2002, and 2003-2004, respectively; P = .04, adjusted for age, sex, and race). Having proteinuria (odds ratio, 3.04 [95% CI, 1.62-5.70]), diabetes (OR, 2.19 [95% CI, 1.03-4.64]), and hypertension (OR, 2.92 [95% CI, 1.57-5.42]) and being male (OR, 2.06 [95% CI, 1.15-3.69]) were all statistically significantly associated with greater awareness among persons with CKD stage 3 after adjustment. Chronic kidney disease awareness increased almost 2-fold for those with CKD stage 3 over recent years but remains low. Persons with risk factors for CKD (proteinuria, diabetes, hypertension, and male sex) were more likely to be aware of their stage 3 disease.


CONCLUSIONS
Renewed and innovative efforts should be made to increase CKD awareness among patients and health care providers.
Plantinga
Laura C
LC
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Boulware
L Ebony
LE
Coresh
Josef
J
Stevens
Lesley A
LA
Miller
Edgar R
ER
Saran
Rajiv
R
Messer
Kassandra L
KL
Levey
Andrew S
AS
Powe
Neil R
NR
D000368:Aged; D001364:Awareness; D003430:Cross-Sectional Studies; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic; D008297:Male; D010361:Patients / Q000523:psychology*; D011507:Proteinuria / Q000150:complications; D012307:Risk Factors; D011795:Surveys and Questionnaires