Awareness Of Chronic Kidney Disease, Its Predictors And Self Management Behaviours Among High Risk Patients In Kenyatta National Hospital.

Abstract

Chronic kidney disease (CKD) is a common and growing problem worldwide. Despite the high worldwide CKD prevalence and the discovery of effective measures to prevent or slow its progression this disease still remains a “silent” epidemic with worldwide limited knowledge on the CKD process and low levels of awareness of CKD in the general population (Coresh et al 2005). In Kenya, a high prevalence (43.3 percent) of late presentation of CKD patients to hospital was noted in 2008(Kilingo 2009). Methods This was a descriptive cross sectional study among a population at high risk of developing CKD attending the outpatient cardiac and diabetic clinics at the Kenyatta National Hospital. Data was collected using a questionnaire to assess awareness of CKD, and selected self-management behaviors among them. A total of 215 clients were selected using the Proportionate Stratified random sampling method. Data was analyzed using SPSS version 20.0. Dependent variable was presented as a median and mode. Independent variables were presented in frequencies and percentages. Associations and differences between the dependent and independent variables were examined using Chi square test. Predictor variables that had significant association with the dependent variable were further subjected into logistic regression analysis to adjust for potential confounders. The level of significance was set at <= 0.05. Results Overall only 98 (45.6%) of the respondents were adequately aware of CKD. A high percentage 158(73.5%) had heard about kidney disease and most 151(70.2%) also reported to have undergone a kidney function test. However, there was limited knowledge noted on CKD. The function of the kidney was the only well-known fact about CKD. 140 (65.1%) of the respondents were aware of the function of the kidney. There was no statistical difference in level of awareness of CKD between those attending the diabetes clinic versus those who attended the cardiovascular clinic. There was a statistically significant relationship between level of education (p=0.009) and monthly income (p=0.044) with awareness of CKD. xiii Conclusion Overall the findings indicate that the clients attending the Cardiac and Diabetic Outpatient Clinic at the Kenyatta National Hospital are inadequately informed on CKD and its complications. A higher level of education and higher income are significantly associated with adequate awareness of CKD. There was no statistically significant relationship between their selected self-management behaviors and the level of CKD awareness. Recommendations Medical practitioners should provide tailored CKD educational programs to clients at risk. The hospital administration should incorporation with the medical practitioners provide avenues of disseminating CKD information to the rest of the population at risk seeking healthcare services in other avenues such as inpatient care. An elaborate qualitative study is needed to explore the role of screening in CKD prevention.