Independent correlates of chronic kidney disease awareness among adults with type 2 diabetes
Independent correlates of chronic kidney disease awareness among adults with type 2 diabetes
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DOI：
10.1016/j.jdiacomp.2017.03.004
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发表时间：
2017-06-01
影响因子：
3
通讯作者：
Egede, Leonard E.
中科院分区：
文献类型：
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作者：
Obadan, Ndidiamaka O.;Walker, Rebekah J.;Egede, Leonard E.
背景：慢性肾脏疾病（CKD）通常是沉默的，直到晚期。对CKD的认识对于减轻不良后果非常重要。本研究旨在了解CKD自我意识与CKD诊断之间的关系。方法：该研究包括来自两个初级保健机构的345名2型糖尿病成人患者。参与者完成了评估人口统计信息、自我保健行为和合并症的调查。生物数据取自医疗记录。以eGFR < 59 ml/min诊断CKD。CKD意识被定义为对“是否有医生、护士或其他健康专业人员告诉过你有肾脏疾病？”和/或“你是否有过需要透析或肾脏移植的肾衰竭？”使用逻辑回归模型来检查CKD意识与临床/社会人口变量之间的关系。结果：31%的研究患者有基于eGFR的CKD（其中只有63%意识到）。逐步回归显示，非西班牙裔黑人（OR = 3.49, p = 0.04）、大学学历（OR = 8.02, p = 0.01）、心肌梗死史（OR = 10.12, p = 0.002）、高血压史（OR = 23.25, p = 0.02）、医疗保险、退伍军人保险或其他保险（OR = 8.08, 8.72, 101.47, p < 0.01）对CKD的知知率显著高于其他人群。有中风或抑郁史的患者（or分别为0.21、0.28,p = 0.03、p = 0.04）对慢性肾病的认识明显较低。结论：CKD知晓率低于CKD诊断率。与意识相关的因素包括种族、教育状况和心血管疾病。提高CKD意识的有针对性的策略可能会改善健康结果。(C) 2017爱思唯尔公司版权所有。
Background: Chronic Kidney Disease (CKD) is usually silent until advanced stages. Awareness of CKD is important to mitigate poorer outcomes. This study aims to understand the relationship(s) between CKD self-awareness and diagnosed CKD.Methods: The study included 345 adults with type 2 diabetes from two primary care settings. Participants completed surveys assessing demographic information, self-care behaviors and co-morbidities. Biological data were taken from medical records. CKD was diagnosed as eGFR = < 59 ml/min. CKD awareness was defined by a positive response to "has a doctor, nurse or other health professional ever told you that you have a kidney disease?" and/or "have you ever had kidney failure that required dialysis or a kidney transplant?" Logistic regression models were used to examine the association between CKD awareness and clinical/socio-demographic variables.Results: 31% of study patients had CKD based on eGFR (of which only 63% were aware). Stepwise regression showed that non-Hispanic blacks (OR = 3.49, p = 0.04), those with college education (OR = 8.02, p = 0.01), history of myocardial infarction (OR = 10.12, p = 0.002) or hypertension (OR = 23.25, p = 0.02), and those with Medicare, VA insurance, or other insurance (OR = 8.08, 8.72, 101.47, respectively, p < 0.01) were significantly more likely to be aware of CKD. Those with a history of stroke or depression (OR = 0.21, 0.28, respectively, p = 0.03, p = 0.04) were significantly less likely to be aware of CKD.Conclusion: CKD awareness was found to be lower than diagnosed CKD rates. Factors associated with awareness include race, educational status and cardiovascular disease. Targeted strategies to increase CKD awareness may lead to improved health outcomes. (C) 2017 Elsevier Inc. All rights reserved.