title: Relationship between Health Literacy and Kidney Function.
abstract: OBJECTIVE
  Low health literacy (HL) may contribute to poor self-management of chronic kidney disease (CKD) and poor kidney function. This study aimed to assess the relationship between HL and estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  A cross-sectional observational study was conducted among consecutive eligible adult patients with CKD stages 1-4 attending an outpatient nephrology clinic. HL was assessed using Newest Vital Sign (NVS). eGFR was estimated using the Modification of Diet in Renal Disease equation. CKD self-management behaviour knowledge was assessed using a study instrument (CKD self-management knowledge (SMKT)).
  
  
  RESULTS
  One hundred fifty patients participated in the study (83% participation rate). The prevalence of high likelihood of limited HL was 32.7%. Participants' eGFRs ranged from 17 to 152 mL/min / 1.73 m(2) , with over 80% of the eGFRs below 60 mL/min / 1.73 m(2) . HL was associated with eGFR after controlling for all demographics except age, race and gender (which are included in eGFR equation) (P = 0.05). Every unit increase in NVS score was associated with a 1.9% increase (95% confidence interval = 0 to 3.86%) in eGFR (model R square = 0.23, P = 0.002), which remained significant after controlling for CKD-SMKT (P = 0.05; model R square = 0.28, P < 0.001). The relationship was non-significant after controlling for age, although it remained significant after controlling for other demographics including gender and race.
  
  
  CONCLUSIONS
  There is a small but significant association between HL and eGFR. Providers should use HL-tailored communication strategies in CKD patients. Larger multicentre studies are needed to substantiate this relationship.
authors: School of Pharmacy, Southern Illinois University Edwardsville, Edwardsville, Illinois, USA.
authors: Radhika
authors: R
authors: Devraj
authors: Matthew
authors: M
authors: Borrego
authors: A Mary
authors: AM
authors: Vilay
authors: Elisa J
authors: EJ
authors: Gordon
authors: Junvie
authors: J
authors: Pailden
authors: Bruce
authors: B
authors: Horowitz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000523:psychology; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D007722:Health Knowledge, Attitudes, Practice; D057220:Health Literacy; D006801:Humans; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000208:ethnology / Q000503:physiopathology* / Q000523:psychology*; D012648:Self Care; D012959:Socioeconomic Factors; D044465:White People / Q000523:psychology; D055815:Young Adult
keywords: CKD; clinical outcome; eGFR; health literacy; kidney function