lass=""h4"">Background
Often, patients with chronic kidney disease are reported to be unaware of it. We prospective
ly eva
luated the association between awareness of kidney disease to end-stage rena
l disease and morta
lity.
lass=""h4"">Methods
We utilized 2000-2009 data from the National Kidney Foundation's Kidney Early Evaluation Program. Mortality was determined by cross reference to the Social Security Administration Death Master File and development of end stage by cross reference with the United States Renal Data System.
lass=""h4"">Results
Of 109,285 participants, 28,244 (26 % ) had chronic kidney disease defined by albuminuria or estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. Only 9 % (n = 2660) reported being aware of kidney disease. Compared with those who were not aware, participants aware of chronic kidney disease had lower eGFR (49 vs 62 mL/min/1.73 m2) and a higher prevalence of albuminuria (52 % vs. 46 % ), diabetes (47 % vs 42 % ), cardiovascular disease (43 % vs 28 % ), and cancer (23 % vs 14 % ). Over 8.5 years of follow-up, aware participants compared with those unaware had a lower rate of survival for end stage (83 % and 96 % ) and mortality (78 % vs 81 % ), P <.001. After adjustment for demographics, socioeconomic factors, comorbidity, and severity of kidney disease, aware participants continued to demonstrate an increased risk for end-stage renal disease (hazard ratio 1.37; 95 % confidence interval, 1.07-1.75; P <.0123) and mortality (hazard ratio 1.27; 95 % confidence interval, 1.07-1.52; P <.0077) relative to unaware participants with chronic kidney disease.
lass=""h4"">Conclusions
Among patients identified as having chronic kidney disease at a health screening, only a small proportion had been made aware of their diagnosis previously by clinicians. This subgroup was at a disproportionately high risk for mortality and end-stage renal disease.
