title: Predictors of patient self-report of chronic kidney disease: baseline analysis of a randomised controlled trial.
abstract: BACKGROUND
  Improving the quality of care for patients with vascular disease is a priority. Clinical guidance has emphasised the importance of early identification and active management of chronic kidney disease (CKD) in primary care in order to maintain vascular health. However, awareness of stage 3 CKD amongst patients remains limited. We aimed to identify predictors of patient self-report of CKD to inform tailoring of conversations around CKD in primary care for diverse patient populations.
  
  
  METHODS
  We conducted a cross-sectional analysis of baseline data from 436 patients with stage 3 CKD from 24 GP practices taking part in a randomised controlled trial (RCT) evaluating a complex self-management intervention, which aimed to support the maintenance of vascular health in patients with stage 3 CKD. Potential predictors of patient self-report of CKD included demographics, stage of CKD, cardiovascular risk, self-reported co-morbidities, health status, self-management ability, and health service utilisation.
  
  
  RESULTS
  Around half (52%, n = 227) of patients did not self-report CKD. Self-report rates did not appreciably differ by practice. Multivariate analysis revealed that female patients (p = 0.004), and patients with stage 3b CKD (p < 0.001), and with higher anxiety levels (p < 0.001), were more likely to self-report CKD.
  
  
  CONCLUSIONS
  Self-report of kidney problems by patients on CKD registers was variable and patterned by sociodemographic factors. Although it cannot be assumed that failure to self-report indicates a lack of awareness of CKD, our data do suggest the need for greater consistency in discussions around kidney health, with meaningful and relevant clinical dialogue that is aligned with existing clinical encounters to enable shared decision making and minimise anxiety.
authors.forename: Hannah
authors.initials: H
authors.lastname: Gaffney
authors.forename: Thomas
authors.initials: T
authors.lastname: Blakeman
authors.forename: Christian
authors.initials: C
authors.lastname: Blickem
authors.forename: Anne
authors.initials: A
authors.lastname: Kennedy
authors.forename: David
authors.initials: D
authors.lastname: Reeves
authors.forename: Shoba
authors.initials: S
authors.lastname: Dawson
authors.forename: Rahena
authors.initials: R
authors.lastname: Mossabir
authors.forename: Peter
authors.initials: P
authors.lastname: Bower
authors.forename: Caroline
authors.initials: C
authors.lastname: Gardner
authors.forename: Victoria
authors.initials: V
authors.lastname: Lee
authors.forename: Anne
authors.initials: A
authors.lastname: Rogers
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D058006:General Practice; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012648:Self Care; D057566:Self Report; D012720:Severity of Illness Index; D012737:Sex Factors