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. 2011 Aug;6(8):1838-44.
doi: 10.2215/CJN.00730111. Epub 2011 Jul 22.

Chronic kidney disease awareness among individuals with clinical markers of kidney dysfunction

Delphine S Tuot  1 , Laura C Plantinga, Chi-Yuan Hsu, Regina Jordan, Nilka Ríos Burrows, Elizabeth Hedgeman, Jerry Yee, Rajiv Saran, Neil R Powe; Centers for Disease Control Chronic Kidney Disease Surveillance Team
Affiliations

Chronic kidney disease awareness among individuals with clinical markers of kidney dysfunction

Delphine S Tuot et al. Clin J Am Soc Nephrol. 2011 Aug.

Abstract

Background and objectives: Awareness of chronic kidney disease (CKD) among providers and patients is low. Whether clinical cues prompt recognition of CKD is unknown. We examined whether markers of kidney disease that should trigger CKD recognition among providers are associated with higher individual CKD awareness.

Design, setting, participants, & measurements: CKD awareness was assessed in 1852 adults with an estimated GFR <60 ml/min per 1.73 m(2) using 1999 to 2008 National Health and Nutrition Examination Survey data. CKD awareness was a "yes" answer to "Have you ever been told you have weak or failing kidneys?" Participants were grouped by distribution of the following abnormal markers of CKD: hyperkalemia, acidosis, hyperphosphatemia, elevated blood urea nitrogen, anemia, albuminuria, and uncontrolled hypertension. Odds of CKD awareness associated with each abnormal marker and groupings of markers were estimated by multivariable logistic regression.

Results: Among individuals with kidney disease, only those with albuminuria had greater odds of CKD awareness (adjusted odds ratio, 4.0, P < 0.01) than those without. Odds of CKD awareness increased with each additional manifested clinical marker of CKD (adjusted odds ratio, 1.3, P = 0.05). Nonetheless, 90% of individuals with two to four markers of CKD and 84% of individuals with ≥5 markers of CKD were unaware of their disease.

Conclusions: Although individuals who manifest many markers of kidney dysfunction are more likely to be aware of their CKD, their CKD awareness remains low. A better understanding of mechanisms of awareness is required to facilitate earlier detection of CKD and implement therapy to minimize associated complications.

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Figures

Figure 1.
Figure 1.
Percentage of individuals with clinical markers of chronic kidney disease (CKD) by estimated GFR and number of abnormal markers of CKD.
Figure 2.
Figure 2.
Adjusted odds ratios and 95% confidence intervals of CKD awareness associated with each additional clinical marker of CKD. (Model 1) unadjusted. (Model 2) Model 1 + demographics (age, gender, race/ethnicity, education). (Model 3) Model 2 + socioeconomic status (income). (Model 4) Model 3 + diabetes. (Model 5) Model 4 + estimated GFR.
Figure 3.
Figure 3.
Adjusted percentage of chronic kidney disease (CKD) awareness and unawareness by number of abnormal clinical markers of CKD. The values are adjusted for age, gender, race/ethnicity, education, income, diabetes, and estimated GFR.
See this image and copyright information in PMC

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