Patient Awareness of CKD: A Systematic Review and Meta-analysis of Patient-Oriented Questions and Study Setting.
Patient Awareness of CKD: A Systematic Review and Meta-analysis of Patient-Oriented Questions and Study Setting.
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DOI：
10.1016/j.xkme.2021.03.014
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发表时间：
2021-07
期刊：
影响因子：
3.9
通讯作者：
Tuot DS
中科院分区：
文献类型：
--
作者：
Chu CD;Chen MH;McCulloch CE;Powe NR;Estrella MM;Shlipak MG;Tuot DS
患者对疾病的认识是有效管理和疾病控制的第一步。人们对慢性肾脏病 (CKD) 的认知度一直较低，但评估患者对 CKD 认知度的研究使用了不同的方法。我们试图确定 CKD 知晓率的估计患病率是否因用于确定知晓度的措辞或设置特征而有所不同。系统回顾和荟萃分析。患有 CKD 的成人未接受透析。我们纳入了评估 CKD 认知度、根据实验室标准确定 CKD 状态的研究，并提供了用于确定认知度的确切问题措辞。 2位评审员独立提取每项研究的数据；不一致之处由第三位独立评审员解决。使用混合效应模型来计算汇总 CKD 知晓率估计值和 95% CI。纳入了 32 项研究。出版年份为 2004 年至 2017 年，研究人群为 107 至 28,923 人。个别研究中的 CKD 知晓率范围为 0.9% 至 94.0%。总体 CKD 知晓率为 19.2%（95% CI，10.0%-33.6%），估计肾小球滤过率 < 60 mL/min/1.73 m2 的个体的总体 CKD 知晓率为 26.5%（95% CI，11.9%-48.9%）。 “肾脏问题”是 CKD 知晓率最敏感的问题（58.7%；95% CI，32.4%-80.8%）； “肾脏虚弱或衰竭”是最不敏感的（12.3%；95% CI，4.5%-29.4%）。肾病科患者对 CKD 的认知度最高（86.2%；95% CI，74.9%-93.0%），而普通人群的认知度最低（7.3%；95% CI，5.0%-10.5%）。总体研究之间以及所检查的措辞和研究背景亚组之间存在显着异质性。不同措辞的问题可能会导致对 CKD 认知度的估计存在很大差异。可能需要一致的术语才能最有效地监测和利用 CKD 意识来改善管理和疾病控制。
Patient awareness of disease is the first step toward effective management and disease control. Awareness of chronic kidney disease (CKD) has consistently been shown to be low, but studies estimating patient awareness of CKD have used different methods. We sought to determine whether the estimated prevalence of CKD awareness differed by the wording used to ascertain awareness or by setting characteristics. Systematic review and meta-analysis. Adults with CKD not receiving dialysis. We included studies that estimated CKD awareness, determined CKD status by laboratory criteria, and provided the exact question wording used to ascertain awareness. 2 reviewers independently extracted data for each study; discordance was resolved by a third independent reviewer. Mixed-effects models were used to calculate pooled CKD awareness estimates and 95% CIs. 32 studies were included. Publication year ranged from 2004 to 2017, with study populations ranging from 107 to 28,923 individuals. CKD awareness in individual studies ranged from 0.9% to 94.0%. Pooled CKD awareness was 19.2% (95% CI, 10.0%-33.6%) overall and was 26.5% (95% CI, 11.9%-48.9%) among individuals with an estimated glomerular filtration rate < 60 mL/min/1.73 m2. “Kidney problem” was the most sensitive question for CKD awareness (58.7%; 95% CI, 32.4%-80.8%); “weak or failing kidneys” was the least sensitive (12.3%; 95% CI, 4.5%-29.4%). CKD awareness was highest among patients from nephrology practices (86.2%; 95% CI, 74.9%-93.0%) and lowest in the general population (7.3%; 95% CI, 5.0%-10.5%). Significant heterogeneity across studies overall and among examined subgroups of wording and study setting. Differently worded questions may lead to widely different estimates of CKD awareness. Consistent terminology is likely needed to most effectively surveil and leverage CKD awareness to improve management and disease control.
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