Public knowledge of chronic kidney disease evaluated using a validated questionnaire: a cross-sectional study

Background: Screening programs may help to address the burden of chronic kidney disease (CKD) in Australia. Public awareness is an important determinant of the uptake of screening programs. However, data on the public knowledge of CKD in Australia is lacking. The aim of this study was to develop a validated questionnaire and assess the Australian public knowledge of CKD. Methods: A CKD knowledge questionnaire was developed after reviewing the literature and discussions with nephrology experts. Content validity was performed by nephrologists (n = 3), renal nurses (n = 3) and research personnel (n = 4). The questionnaire was piloted in 121 public participants. Next, discriminant validation was performed by recruiting two additional groups of participants: final year undergraduate pharmacy students (n = 28) and nephrologists (n = 27). Reliability of the questionnaire was assessed by calculating Cronbach’s alpha. Next, a cross-sectional survey of the Australian public (n = 943) was conducted by using the validated questionnaire. It was administered using an online Omnibus survey. Quota sampling was used for participant selection and to ensure that the final sample would match the key characteristics of the Australian population. Finally, a standard multiple regression analysis was performed to identify predictors of the public knowledge. Results: The median CKD knowledge scores of the public, students and nephrologists were 12, 19 and 23 (maximum score of 24), respectively, with statistically significant differences in the scores across the three groups (p < 0.001; Kruskal-Wallis test). The Cronbach’s alpha was 0.88 (95% CI: 0.86–0.91), indicating that the questionnaire had good internal consistency. In the cross-sectional survey of the Australian public, the participants’ mean (SD) age was 47.6 (±16.6) years and 51.2% were female. The mean (SD) knowledge score was 10.3 (± 5.0). The multivariate analysis showed that participants with a higher level of education; with a family history of kidney failure; with a personal history of diabetes; and currently or previously living in a relationship had significantly higher knowledge scores. Conclusion: The Australian public knowledge of CKD was relatively poor. Improving public knowledge may assist in increasing early detection and subsequent management of CKD in Australia

Effectiveness of targeted screening for chronic kidney disease in the community setting: a systematic review

Background: Targeted screening interventions for chronickidney disease (CKD) are increasingly being implementedin various community settings. However, the overall successof these programs is uncertain. Therefore, the aim ofthis review is to determine whether targeted screening iseffective in detecting people with undiagnosed CKD.Methods: We performed a systematic literature review,and included studies of targeted screening interventionimplemented in any community-based setting. Studies wererequired to have targeted people aged≥18 years, and multipleCKD risk factors from the following: diabetes, hypertension,cardiovascular disease and family history of kidneydisease. The outcome measures were percentages of participantswith positive screening test results and diagnosedwith CKD at follow-up.Results: Nine studies met the inclusion criteria. Eightstudies reported the percentage of participants with positivescreening test results, which ranged from 7 to 60.3%. Onlytwo studies repeated the diagnostic tests to detect CKD,and confirmed the chronicity of CKD in 20.5 and 17.1%of screened participants. The most commonly used screeningtests were albumin creatinine ratio (≥3.4  mg/mmol),and estimated glomerular filtration rate (eGFR) (Conclusions: This systematic review found significantvariation in the methods that were used to detect CKD,with the majority of studies reporting results based on onlysingle albuminuria or eGFR values. Future targeted screeningprograms should appropriately use the 2012 KDIGOguidelines in order to detect CKD, which is necessary todetermine the benefit of these programs when implementedin community-settings