Waterman Amy D, Browne Teri, Waterman Brian M, Gladstone Elisa H, Hostetter Thomas
Internal Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
Am J Kidney Dis. 2008 Apr;51(4):554-62. doi: 10.1053/j.ajkd.2007.12.020. Epub 2008 Mar 6.
Chronic kidney disease (CKD) is an African American public health crisis. To inform interventions, the National Kidney Disease Education Program surveyed African Americans about their attitudes and behaviors regarding early detection of kidney disease and screening.
Cross-sectional study.
SETTING & PARTICIPANTS: 2,017 African Americans from 7 states (Georgia, Maryland, Ohio, Mississippi, Louisiana, Missouri, and Tennessee) selected by using a random-digit dialing telephone survey (response rate, 42.4%).
Demographic, risk, knowledge, and behavior variables.
OUTCOMES & MEASUREMENTS: Perception of CKD as a top health concern, perceived risk of getting kidney disease, and accurate knowledge about CKD and its prevention.
Only 23.5% of African Americans were screened for kidney disease in the last year. Although almost half (43.7%) of African Americans had a CKD risk factor, only 2.8% reported that CKD was a top health concern. Almost half knew the correct definition of kidney disease (48.6%), but few knew a test to diagnose CKD (23.7%) or that African Americans were at greater risk of developing CKD (18.1%). African Americans who had diabetes (odds ratio [OR], 3.22; 95% confidence interval [CI], 2.17 to 4.76), hypertension (OR, 1.78; 95% CI, 1.28 to 2.44), at least a bachelor's degree (OR, 1.77; 95% CI, 1.17 to 2.66), who had spoken with a medical professional (OR, 1.85; 95% CI, 1.19 to 2.85) or their family (OR, 1.61; 95% CI, 1.11 to 2.38) about kidney disease, who knew that a family history of kidney disease is a risk factor (OR, 2.32; 95% CI, 1.08 to 5.0), and who had been tested for CKD in the last year (OR, 1.45; 95% CI, 1.03 to 2.0) were more likely to correctly perceive themselves at increased risk.
Respondents were primarily African American women from urban areas.
Most African Americans have poor knowledge about CKD, do not perceive it as an important health problem, and are not getting screened. To increase early detection of kidney disease through screenings, educational efforts linking kidney disease prevention to other diseases that are health priorities for African Americans are necessary.
慢性肾脏病(CKD)是美国非裔面临的公共卫生危机。为指导干预措施,国家肾脏疾病教育计划就非裔美国人对肾脏疾病早期检测和筛查的态度及行为进行了调查。
横断面研究。
通过随机数字拨号电话调查从7个州(佐治亚州、马里兰州、俄亥俄州、密西西比州、路易斯安那州、密苏里州和田纳西州)选取了2017名非裔美国人(应答率为42.4%)。
人口统计学、风险、知识及行为变量。
将CKD视为首要健康问题的认知、患肾脏疾病的感知风险以及关于CKD及其预防的准确知识。
去年仅有23.5%的非裔美国人接受了肾脏疾病筛查。尽管近一半(43.7%)的非裔美国人有CKD风险因素,但只有2.8%的人报告称CKD是首要健康问题。近一半的人知道肾脏疾病的正确定义(48.6%),但很少有人知道诊断CKD的检测方法(23.7%)或非裔美国人患CKD的风险更高(18.1%)。患有糖尿病(比值比[OR],3.22;95%置信区间[CI],2.17至4.76)、高血压(OR,1.78;95%CI,1.28至2.44)、至少拥有学士学位(OR,1.77;95%CI,1.17至2.66)、曾与医疗专业人员(OR,1.85;95%CI,1.19至2.85)或其家人(OR,1.61;95%CI,1.11至2.38)谈论过肾脏疾病、知道家族肾脏病史是风险因素(OR,2.32;95%CI,1.08至5.0)以及去年接受过CKD检测(OR,1.45;95%CI,1.03至2.0)的非裔美国人更有可能正确地意识到自己患病风险增加。
受访者主要是来自城市地区的非裔美国女性。
大多数非裔美国人对CKD了解甚少,不将其视为重要的健康问题,也未接受筛查。为通过筛查增加肾脏疾病的早期检测,有必要开展教育工作,将肾脏疾病预防与非裔美国人健康优先关注的其他疾病联系起来。