Associations between access to care and awareness of CKD.
Associations between access to care and awareness of CKD.
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DOI：
10.1053/j.ajkd.2011.10.042
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发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
KEEP Investigators
中科院分区：
文献类型：
--
作者：
Shah A;Fried LF;Chen SC;Qiu Y;Li S;Cavanaugh KL;Norris KC;Whaley-Connell AT;McCullough PA;Mehrotra R;KEEP Investigators
在美国，大多数慢性肾脏疾病(CKD)患者并不知道自己的病情，这给实施早期干预以延缓疾病进展带来了挑战。预期将提高卫生保健可获得性的特征是否与更多的慢性肾脏病意识相关，尚未得到充分研究。分析了2000-2010年国家肾脏基金会肾脏早期评估计划(Keep)志愿者的数据，并推定为CKD(估计的肾小球滤过率[EGFR]和lt；60mL/min/1.73m2或白蛋白-肌酐比率&30 mg/g)。鉴于慢性肾脏病的诊断是基于单一的肾功能测量，诊断是推定的，但没有得到证实。使用Logistic回归分析CKD意识与获得护理的措施(医疗保险覆盖范围、健康保险类型、处方药覆盖范围和自我报告的难以获得护理的程度)之间的关系。在29,144名CKD参与者中，6,751人(23%)报告了CKD意识。未发现健康保险或处方药的可获得性与CKD知晓率之间的显著关联；结果没有因糖尿病状况或仅限于EGFR为60毫升/分钟/1.73平方米的参与者而改变。报告极端或一些医疗困难的参与者比那些报告没有困难的参与者更有可能意识到CKD(调整后的OR，1.25；95%CI，1.05-1.50)。大多数患有CKD的Keep参与者不知道病情，结果不会因医疗保险或处方药覆盖范围的可获得性而改变。认为获得护理的困难与更多的慢性肾脏病意识相关联的潜在机制需要进一步研究。
Most individuals with chronic kidney disease (CKD) in the United States are unaware of their condition, creating challenges in implementing early interventions to delay disease progression. Whether characteristics expected to enhance health care access are associated with greater CKD awareness has not been studied adequately. Data from volunteer participants in the National Kidney Foundation’s Kidney Early Evaluation Program (KEEP), 2000-2010, with presumed CKD (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2 or albumin-creatinine ratio >30 mg/g) were analyzed. Given that the diagnosis of CKD was based on a single measurement of kidney function, the diagnosis is presumed, but not confirmed. Associations of CKD awareness with measures of access to care (health insurance coverage, type of health insurance, prescription drug coverage, and self-reported level of difficulty obtaining care) were examined using logistic regression. Of 29,144 participants with CKD, 6,751 (23%) reported CKD awareness. No significant association was found between availability of health insurance or prescription drug coverage and CKD awareness; results did not vary by diabetic status or in analyses restricted to participants with eGFR <60 mL/min/1.73 m2. Participants reporting extreme or some difficulty obtaining medical care were more likely than those reporting no difficulty to be aware of CKD (adjusted OR, 1.25; 95% CI, 1.05-1.50). Most KEEP participants with CKD are unaware of the condition, results that are not modified by the availability of health insurance or prescription drug coverage. The mechanisms underlying the association of perceived difficulty in access to care with greater CKD awareness require further study.
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DOI：
10.1097/01.asn.0000112129.20838.3f
发表时间：
2004-03-01
影响因子：
13.6
作者：
Parker, TF;Blantz, R;Weiss, J
通讯作者：
Weiss, J
影响因子：
13.2
作者：
Nickolas, TL;Frisch, GD;Radhakrishnan, J
通讯作者：
Radhakrishnan, J
影响因子：
39.2
作者：
Levey AS;Stevens LA;Schmid CH;Zhang YL;Castro AF 3rd;Feldman HI;Kusek JW;Eggers P;Van Lente F;Greene T;Coresh J;CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
通讯作者：
CKD-EPI (Chronic Kidney Disease Epidemiology Collaboration)
影响因子：
13.6
作者：
Coresh, J;Byrd-Holt, D;Hostetter, TH
通讯作者：
Hostetter, TH
影响因子：
5.7
作者：
Rakhit, D. J.;Marwick, T. H.;Isbel, N. M.
通讯作者：
Isbel, N. M.