Chronic Kidney Disease

By:  Christin Iroegbu PhD, RN

Published March 3, 2023

Chronic kidney disease (CKD) is a common and prevalent condition in the United States. It is defined as kidney damage or a glomerular filtration rate (GFR) less than 60 mL/min/1.73m2) for three months or longer.4 If untreated, CKD can progress to end stage renal disease (ESRD), an irreversible and fatal condition only treated with dialysis or kidney transplant.8 With an aging population and an increasing incidence of chronic illnesses such as high blood pressure and diabetes, the number of individuals at risk for CKD will continue to rise.7 It has been consistently documented that Black and Hispanic patients experience faster progression of CKD with several-fold greater incidence of end stage kidney disease when compared to their White counterparts.2 These inequities are largely driven by social determinants of health and the widespread disparities in diagnosis and treatment.1,3 Even with the significant costs and prevalence associated with CKD, 90% of adults in the United States with kidney disease are unaware of their diagnosis.5

Primary Care Providers (PCPs) are often the first point of care and can provide the most impact to detecting, monitoring, and managing the progression of CKD during the earlier stages. This placed them in the best position to communicate disease-specific information and strategies that work to prevent the development or slow the progression of CKD.6 You are at greater risk for kidney disease if you have heart disease, high blood pressure, diabetes, obesity, older in age, inherited kidney disease, a family history of chronic kidney disease or previous kidney damage. If you are at risk for kidney disease or believe you may be at risk for kidney disease, screening can be done by PCP with a simple blood or urine test.  Schedule an appointment or ask your PCP to find it early and treat it early.

If you have been diagnosed with CKD and would like to share your story and experience receiving your diagnosis, the University of Pennsylvania School of Nursing is conducting a research study on patient’s experiences communicating with their providers about their diagnosis. Eligible candidates will receive a $15 Amazon gift card for participation. Complete this survey to see if you are eligible and you will be contacted with the next steps. Questions about the study? Contact Dr. Christin Iroegbu PhD, RN at ckiregb@nursing.penn.edu or 215.385.5209.

References:

  1. Brown, J. S., & Elliott, R. W. (2021). Social Determinants of Health: Understanding the Basics and Their Impact on Chronic Kidney Disease. Nephrology Nursing Journal : Journal of the American Nephrology Nurses’ Association, 48(2), 131–145. https://doi.org/10.37526/1526-744x.2021.48.2.131
  2. Chu, C. D., Powe, N. R., McCulloch, C. E., Crews, D. C., Han, Y., Bragg-Gresham, J. L., Saran, R., Koyama, A., Burrows, N. R., & Tuot, D. S. (2021). Trends in Chronic Kidney Disease Care in the US by Race and Ethnicity, 2012-2019. JAMA Network Open, 4(9), 2012–2019. https://doi.org/10.1001/jamanetworkopen.2021.27014
  3. Crews, D. C., & Novick, T. K. (2020). Achieving equity in dialysis care and outcomes: The role of policies. Seminars in Dialysis, 33(1), 43–51. https://doi.org/10.1111/sdi.12847
  4. Hoerger, T. J., Simpson, S. A., Yarnoff, B. O., Pavkov, M. E., Ríos Burrows, N., Saydah, S. H., Williams, D. E., & Zhuo, X. (2015). The future burden of CKD in the United States: A simulation model for the CDC CKD initiative. American Journal of Kidney Diseases, 65(3), 403–411. https://doi.org/10.1053/j.ajkd.2014.09.023
  5. Iroegbu, C., Lewis, L., & Matura, L. A. (2021). An integrative review: Chronic kidney disease awareness and the social determinants of health inequities. Journal of Advanced Nursing, October, 1–11. https://doi.org/10.1111/jan.15107
  6. Prieto, R. (2016). Preventing Progression of End Stage Renal Diseas: A Systematic Review of Patient-Provider Communication in Primary Care. University of Arizona.
  7. Szczech, L. A., Stewart, R. C., Su, H.-L., DeLoskey, R. J., Astor, B. C., Fox, C. H., McCullough, P. A., & Vassalotti, J. A. (2014). Primary care detection of chronic kidney disease in adults with type-2 diabetes: the ADD-CKD Study (awareness, detection and drug therapy in type 2 diabetes and chronic kidney disease). PloS One, 9(11), e110535. https://doi.org/10.1371/journal.pone.0110535
  8. Yann Ng, C., Shiun Lee, Z., Seong Goh, K., Ng, C. Y., Lee, Z. S., & Goh, K. S. (2016). Cross-sectional study on knowledge of chronic kidney disease among medical outpatient clinic patients. Medical Journal of Malyasia, 71(3), 99–104. http://wprim.whocc.org.cn/admin/article/downloadAppendix?article=/upload/articleFile/P020160808581369829177.pdf&articleId=630744