Knowledge, attitude and practices regarding chronic kidney disease and estimated GFR in a tertiary care hospital in Pakistan.

OBJECTIVE

To assess knowledge, attitude and practices regarding Chronic kidney disease (CKD) and referral to Nephrologists on the basis of estimated Glomerular filtration rate (eGFR) reporting with Modification of Diet in Renal Disease (MDRD).

METHODS

This is a cross-sectional study. It was conducted at Shifa International Hospital, Islamabad in January 2008. A questionnaire-based survey was conducted to achieve the study objectives. Study subjects included consultants and residents from medicine, surgery, urology, gynaecology and obstetrics, as they are the main referral source to Nephrologists. Participants were asked to give their views on 09 questions.

RESULTS

A paper based questionnaire was used to survey 114 subjects. Majority of the study subjects (78.07%) were aware that eGFR is better than raised serum creatinine alone, in assessing severity of kidney disease. Though, 48.28% of the subjects were not aware when to refer, based on eGFR. However, 84.21% of the respondents knew implications of late referral (morbidity and mortality) but despite that, 55.26% would still not refer to nephrologists even if it was indicated. Residents were more likely to refer to a Nephrologist early as compared to consultants.

CONCLUSION

Our study shows that there is a need for continuing education and awareness among physicians regarding CKD management and benefits of timely referral to a nephrologist. This may have a significant impact on CKD management and outcome of these patients in a developing country with financial restraints.