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Awareness, self-management behaviors, health literacy and kidney function relationships in specialty practice

World Journal of Nephrology 2018年第1期7卷 41-50页

作者： Radhika Devraj Matthew E Borrego A Mary Vilay Junvie Pailden bruce horowitz School of Pharmacy Southern Illinois University Edwardsville College of Pharmacy University of New Mexico College of Arts and Sciences Southern Illinois University Edwardsville Division of Nephrology and Hypertension University of Utah

AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.

关键词： Chronic kidney disease awareness Health literacy Kidney function Self-management behaviors Self-management behavior performance Epidermal growth factor receptor Chronic kidney disease knowledge

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Nephropathy in dietary hyperoxaluria:A potentially preventable acute or chronic kidney disease

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World Journal of Nephrology 2014年第4期3卷 122-142页

作者： Robert H Glew Yijuan Sun bruce L horowitz Konstantin N Konstantinov Marc Barry Joanna R Fair Larry Massie Antonios H Tzamaloukas Department of Surgery University of New Mexico School of Medicine Renal Section Raymond G Murphy Veterans Affairs (VA) Medical Center and Department of MedicineUniversity of New Mexico School of Medicine Division of Nephrology Department of MedicineUniversity of New Mexico School of Medicine Rheumatology Section Raymond G Murphy VA Medical Center and Department of MedicineUniversity of New Mexico School of Medicine Department of Pathology University of New Mexico School of Medicine Radiology Service Raymond G Murphy VA Medical Center and Department of RadiologyUniversity of New Mexico School of Medicine Pathology Section Raymond G Murphy VA Medical Center and Department of PathologyUniversity of New Mexico School of Medicine

Hyperoxaluria can cause not only nephrolithiasis and nephrocalcinosis,but also renal parenchymal disease histologically characterized by deposition of calcium oxalate crystals throughout the renal parenchyma,profound tubular damage and interstitial inflammation and *** nephropathy presents clinically as acute or chronic renal failure that may progress to endstage renal disease(ESRD).This sequence of events,well recognized in the past in primary and enteric hyperoxalurias,has also been documented in a few cases of dietary *** of oxalate intake in patients with chronic dietary hyperoxaluria who developed chronic kidney disease or ESRD were comparable to the reported average oxalate content of the diets of certain populations worldwide,thus raising the question whether dietary hyperoxaluria is a primary cause of ESRD in these *** addressing this question have the potential of improving population health and should be undertaken,alongside ongoing studies which are yielding fresh insights into the mechanisms of intestinal absorption and renal excretion of oxalate,and into the mechanisms of development of oxalate-induced renal parenchymal *** preventive and therapeutic strategies for treating all types of hyperoxaluria are expected to develop from these studies.

关键词： Dietary hyperoxaluria Chronic oxalatenephropathy Acute oxalate nephropathy Acute tubular necrosis Interstitial nephritis Nephrocalcinosis Calcium oxalate nephrolithiasis Oxalate transporters Inflammasomes

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