title: Kidney disease health literacy among new patients referred to a nephrology outpatient clinic.
abstract: BACKGROUND
  Knowledge about kidney disease among the general population is poor but has not been assessed in the population selected for referral to nephrology care.
  
  
  OBJECTIVE
  This study aimed to determine patients' understanding of chronic kidney disease (CKD) when first presenting to a nephrology clinic.
  
  
  METHODS
  Newly referred patients to a nephrology clinic were surveyed with open-ended questions about their understanding of CKD causes, symptoms and management.
  
  
  RESULTS
  Two hundred and ten patients were surveyed. Median age was 66.5 years (interquartile range 52-77), 50.5% female and mean body mass index 29.7 ± 6.8 kg/m(2) . Prevalence of risk factors for CKD included 31% diabetic, 62% hypertension, 19% family history of CKD and 2% Aboriginal or Torres Strait Islander. CKD stage prevalence was 0 (8%), 1 (24%), 2 (11%), 3 (38.5%), 4 (18%) and 5 (0.5%). Eighty-two per cent were referred by their primary care physician and 29% had seen a nephrologist previously. Kidney Health Australia was mentioned by 2.4%. Sixteen per cent were unsure why they had been referred. CKD causes identified by patients were unsure (40%), alcohol (29%), hypertension (16%) and diabetes (14%). Symptoms identified included asymptomatic (16%), kidney pain (17%) and other (42%). Management suggested by patients was uncertain (51%), dialysis (32%) and anti-hypertensive medication (16%). Eighty-two per cent reported unsatisfactory education from their primary care physician.
  
  
  CONCLUSIONS
  New patients referred to a renal outpatient department had poor knowledge about kidney disease. Education of patients should begin in primary care prior to referral. For most patients, education programmes need to be targeted at a simplistic level.
authors.affiliation: Department of Nephrology, Princess Alexandra Hospital, Brisbane, Australia; School of Medicine, The University of Queensland, Brisbane, Australia.
authors.forename: M T
authors.initials: MT
authors.lastname: Burke
authors.forename: J
authors.initials: J
authors.lastname: Kapojos
authors.forename: C
authors.initials: C
authors.lastname: Sammartino
authors.forename: N A
authors.initials: NA
authors.lastname: Gray
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009398:Nephrology / Q000379:methods*; D010353:Patient Education as Topic / Q000379:methods; D012017:Referral and Consultation; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy
keywords: chronic kidney disease; health literacy; knowledge; questionnaire; survey