Patient Knowledge of Diabetes and CKD in an Inner-City Population

Patient education is a component of prevention of progression of kidney disease. Paul Flynn and colleagues at SUNY Downstate Health Science University, Brooklyn, New York, interviewed patients with end-stage kidney disease (ESKD) secondary to diabetic kidney disease to determine their knowledge of their disease and how it relates to chronic kidney disease (CKD).

Results of the interviews were reported during a poster session at the NKF 2022 Spring Clinical Meetings. The poster was titled Knowledge Gaps Regarding Chronic Kidney Disease and Diabetes in a Population of Inner-City Dialysis Patients.

The survey was administered to 15 randomly selected dialysis patients with diabetes. The survey included questions about patient knowledge about diabetes and kidney disease at the time of diagnosis. The researchers also collected demographic information.

Mean age of the respondents was 64.3 years, 53% (n=8) were male, 47% (n=7) had less than a college education, 89% (n=8/9) made less than $40,000 per year. Mean time with diabetes was 29.0 years. Eight of 13 patients saw an endocrinologist, and four reported most recent hemoglobin A1c (HbA1c) >10%. Twelve of 13 respondents reported they had no knowledge of what CKD was and 10 of 13 did not know at the time of  their diabetes diagnosis that diabetes could cause kidney disease.

There was no correlation between knowledge and age, education, length of time with diabetes, income, or sex. Patients who were older were lesse likely to see an endocrinologist (r=0.64; P=.019), checked their glucose less frequently (r=0.71; P=.006), and did not check after eating (r=0.62; P=.023). Thirteen of 14 patients said they did know what HbA1c was, 11 of 14 knew that insulin decreases blood glucose levels, 12 of 14 knew that a person with type 2 diabetes had increased blood glucose, and ten of 14 patients knew that HbA1c should be checked every 3 months. Six of 13 patients did not know what a nephrologist is and nine of 13 did not know how kidney function is measured.

In summary, the authors said, “In our population of inner-city dialysis patients with diabetes mellitus: (1) The majority were knowledgeable about diabetes, although older patients were less likely to see an endocrinologist and check their blood sugar frequently or after eating. (2) The majority of patients had no knowledge of kidney disease and did not know that diabetes could cause kidney disease at the time of their diagnosis. (3) Almost half of patients currently did not know what a nephrologist was and did not know how kidney function is measured. (4) An early education program for our underserved population regarding the relationship between kidney disease and diabetes should be designed in the hopes of delaying progression to ESKD.”

Source: Flynn P, Sherman B, Wei L, et al. Knowledge gaps regarding chronic kidney disease and diabetes in a population of inner-city dialysis patients. Abstract of a poster presented at the National Kidney Foundation 2022 Spring Clinical Meetings (Abstract 273), Boston, Massachusetts, April 6-10, 2022.