Hospitalized patients frequently unaware of their chronic kidney disease

Abstract

Prior studies have found that outpatients are frequently unaware of their chronic kidney disease (CKD). Little is known about CKD awareness in hospitalized patients. We conducted a retrospective study of general medicine inpatients with CKD, ascertained through International Classification of Diseases, Ninth Revision codes for non-dialysis-dependent CKD (585.0-585.9) in their first 20 admission diagnoses (n = 590). Patient awareness of their CKD, defined as correct patient self-report of "kidney problems" was 32%. Of 161 patients with advanced CKD, 48% of patients with stage 4 (estimated glomerular filtration rate [eGFR] 15-29) and 63% with stage 5 (eGFR <15) reported having CKD. In multivariable analysis, factors significantly associated with patient self-report of CKD included advanced CKD stage, other race (nonwhite, non-African American), and increasing Mini-Mental State Exam score (all P < 0.05). CKD awareness increased, but remained low, in patients with advanced CKD who would benefit from referral to multidisciplinary nephrology care. Hospitalization provides an opportunity to educate patients with CKD and link them to care.