Document Detail


Associations between access to care and awareness of CKD.
MedLine Citation:
PMID:  22339898     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: 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.
METHOD: 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 m(2) 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.
RESULTS: 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 m(2). 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).
CONCLUSIONS: 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.
Authors:
Anuja Shah; Linda F Fried; Shu-Cheng Chen; Yang Qiu; Suying Li; Kerri L Cavanaugh; Keith C Norris; Adam T Whaley-Connell; Peter A McCullough; Rajnish Mehrotra;
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  59     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-20     Completed Date:  2012-04-23     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S16-23     Citation Subset:  IM    
Copyright Information:
Published by Elsevier Inc.
Affiliation:
Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA 90502, USA.
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Diagnostic Self Evaluation
Female
Health Knowledge, Attitudes, Practice*
Health Services Accessibility / statistics & numerical data*
Humans
Kidney Diseases / diagnosis*
Male
Middle Aged
Grant Support
ID/Acronym/Agency:
DK K23080952/DK/NIDDK NIH HHS; K23 DK080952/DK/NIDDK NIH HHS; MD000182/MD/NIMHD NIH HHS; P20 MD000182/MD/NIMHD NIH HHS; P30 AG021684/AG/NIA NIH HHS; R03 AG040638/AG/NIA NIH HHS; R03AG040638-01/AG/NIA NIH HHS; R21 DK077341/DK/NIDDK NIH HHS; R21 DK077341/DK/NIDDK NIH HHS; RR026138/RR/NCRR NIH HHS; U54 MD007598/MD/NIMHD NIH HHS; UL1 TR000124/TR/NCATS NIH HHS
Investigator
Investigator/Affiliation:
Peter A McCullough / ; Adam T Whaley-Connell / ; Andrew Bomback / ; Kerri Cavanaugh / ; Linda Fried / ; Claudine Jurkovitz / ; Mikhail Kosiborod / ; Samy McFarlane / ; Rajnish Mehrotr / ; Keith Norris / ; Rulan Savita Parekh / ; Carmen A Peralta / ; Georges Saab / ; Stephen Seliger / ; Michael Shlipak / ; Lesley Inker / ; Manjula Kurella Tamura / ; John Wang / ; Bryan Becker / ; Allan Collins / ; Nilka Ríos Burrows / ; Lynda A Szczech / ; Joseph Vasssalott / ; George Bakris / ; Wendy Brown / ; Shu-Cheng Chen /
Comments/Corrections

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