Author(s): Malheiro, Jorge ; Araújo, Francisco ; Nunes, Andreia ; Almeida, Clara ; Aires, Inês ; Nobre, João Pedro ; Neves, João Sérgio ; Dias, Jordana ; Bigotte Vieira, Miguel ; Melo, Miguel ; Capela, Nuno ; Heitor, Susana ; Couceiro, João ; Martinho, Hugo ; Luz-Duarte, Leonor ; Taveira-Gomes, Tiago
Date: 2024
Origin: Portuguese Kidney Journal (PKJ)
Subject(s): Awareness; Consensus; Renal Insufficiency, Chronic
Introduction: The global prevalence of chronic kidney disease (CKD) is rising exponentially. While patient awareness of CKD remains low, we studied the physicians’ awareness and how globally it can be improved. We aimed to evaluate the awareness and consensus of physicians on the screening, diagnosis and clinical management of CKD, thus identifying which areas should be the subject of educational or research programs. Methods: Participants experienced in scientific research and interested in CKD were divided into two groups: primary and secondary care physicians. They underwent the Awareness Round with four open questions, followed by a Consensus Round to rate their level of agreement using a five‐point Likert scale‐ Jandhyala method. Results: Results showed varying levels of awareness and consensus among primary and secondary care physicians. Both groups identified diabetes and hypertension as major risk factors for CKD development and progression, with high consensus indexes (CI). However, glomerulopathies, polycystic kidney disease, and acute kidney injury had low awareness indexes (AI) but high CI, especially in secondary care. Key barriers to CKD diagnosis in primary care included physician inertia (AI 100%) and lack of articulation between specialties (AI 77%). In secondary care, therapeutic inertia (AI 100%) and socioeconomic factors (AI 84%) were significant limitations. Additionally, there was a notable disparity in the management of CKD between primary and secondary care. Primary care showed lower AI for promoting a healthy lifestyle (49%) and avoiding nephrotoxic drugs (25%) compared to secondary care (100% and 79%, respectively). Conclusion: There is a need for educational programs for physicians exploring topics such as polycystic kidney disease, glomerulopathies and acute kidney disease; as well as the implementation of initiatives focused on CKD referral and management.
