چکیده (انگلیسی):

Background:Improving the quality of care for patients with vascular disease is a priority. Clinical guidance has
emphasised the importance of early identification and active management of chronic kidney disease (CKD) in
primary care in order to maintain vascular health. However, awareness of stage 3 CKD amongst patients remains
limited. We aimed to identify predictors of patient self-report of CKD to inform tailoring of conversations around
CKD in primary care for diverse patient populations.
Methods:We conducted a cross-sectional analysis of baseline data from 436 patients with stage 3 CKD from 24 GP
practices taking part in a randomised controlled trial (RCT) evaluating a complex self-management intervention,
which aimed to support the maintenance of vascular health in patients with stage 3 CKD. Potential predictors of
patient self-report of CKD included demographics, stage of CKD, cardiovascular risk, self-reported co-morbidities,
health status, self-management ability, and health service utilisation.
Results:Around half (52%, n = 227) of patients did not self-report CKD. Self-report rates did not appreciably differ by
practice. Multivariate analysis revealed that female patients (p= 0.004), and patients with stage 3b CKD (p< 0.001), and
with higher anxiety levels (p< 0.001), were more likely to self-report CKD.
Conclusions:Self-report of kidney problems by patients on CKD registers was variable and patterned by
sociodemographic factors. Although it cannot be assumed that failure to self-report indicates a lack of awareness
of CKD, our data do suggest the need for greater consistency in discussions around kidney health, with meaningful
and relevant clinical dialogue that is aligned with existing clinical encounters to enable shared decision making and
minimise anxiety.