Results from a recent study published in the Journal of Hospital Medicine showed that patient awareness of their chronic kidney disease diagnosis is low and that hospitalization provides an opportunity to educate patients and link them to care.
Chronic kidney disease (CKD) affects over 13% of the US population and is associated with increased morbidity, mortality, and healthcare costs. However, only 10% of individuals with CKD are aware of their diagnoses, even though progression of kidney disease can be slowed by patient self-management of diabetes and hypertension. Patient awareness of CKD may also increase acceptance of pre–end-stage renal disease (ESRD) patient education and nephrology referral, which have been shown to delay CKD progression and improve clinical status at dialysis initiation. However, only 60% of patients with advanced CKD have visited a nephrologist in the past year or have seen a nephrologist prior to dialysis initiation.
Hospitalization represents an opportunity to identify existing CKD and to use a multidisciplinary approach to preventative care, patient education, and patient-provider planning for renal replacement therapy needs.
In the study entitled “Hospitalized Patients Frequently Unaware of Their Chronic Kidney Disease”, Milda Saunders, MD, University of Chicago Medical Center and colleagues conducted a retrospective study of general medicine inpatients with CKD, in their first 20 admission diagnoses (n=590). Results revealed only 32% of patients were aware of their CKD. Of the 161 patients in an advanced stage of the condition, 48% (stage 4, eGFR = 15–29) and 63% (stage = eGFR <15) reported having CKD. Results also showed patient self-report of CKD was associated with an advanced stage of the condition, being from a nonwhite, non-African American background, and increasing Mini-Mental State Exam score. The researchers also found that during hospitalization CKD awareness increased but remained low, in patients with advanced CKD who would benefit from referral to multidisciplinary nephrology care.
Based on these findings, researchers concluded that hospitalized CKD patients have a low CKD awareness. The investigators suggest that patient awareness of their CKD must be coupled with provider awareness and CKD documentation to link patients to multidisciplinary education and care, this way slowing CKD progression and reducing associated cardiovascular and metabolic complications.