CKD Awareness Is Rising, but Remains Low

Despite efforts to increase awareness, a large majority of Americans with chronic kidney disease (CKD) are still unaware of their disease, reports a study in the Archives of Internal Medicine.

Led by Laura C. Plantinga, ScM, of Johns Hopkins Bloomberg School of Public Health, Baltimore, the study included 2992 adults with stage 1 to 4 CKD from the National Health and Nutrition Examination Survey, 1999–2004. Patients were asked whether they had ever been told they had “weak or failing kidneys.”

Awareness of CKD increased during the study period only in patients with stage 3 disease: from 4.7 percent in 1999–2000 to 9.2 percent in 2003–04. For patients with stage 1 or 2 CKD, the rate of awareness was about half of that for those in stage 3. Even in stage 4, less than half of respondents were aware of their CKD.

Factors associated with awareness were assessed in 1314 patients with stage 3 CKD. Those with proteinuria or hypertension were about three times more likely to be aware of their disease. Rates of awareness were twice as high for diabetics and for males. Awareness was unrelated to having a regular site for health care, educational attainment, insurance status, or obesity.

Recent guidelines have emphasized the need for early detection and prevention of CKD. The new results suggest that awareness of stage 3 CKD has nearly doubled in recent years, but remains low. The authors urge more aggressive targeting of groups with low awareness of CKD, including older patients, women, and patients without diabetes or hypertension [Plantinga LC, Boulware LE, Coresh J, Stevens LA, Miller ER III, Saran R, Messer KL, Levey AS, and Powe NR: Patient awareness of chronic kidney disease: trends and predictors. Arch Intern Med 2008; 168:2268–2275].