NAU ‐ New NAU - Areas of Unifying Interest for CKD: A Multidisciplinary Expert Opinion Using the Jandhyala Method

Authors

  • Jorge Malheiro Nephrology Department, Centro Hospitalar e Universitário de Santo António, ULS de Santo António, Porto, Portugal; Instituto de Ciências Biomédicas de Abel Salazar Universidade do Porto (ICBAS/UP), Porto, Portugal Author https://orcid.org/0000-0002-9625-5889
  • Francisco Araújo Internal Medicine Department, Hospital Lusíadas, Lisbon, Portugal Author https://orcid.org/0000-0002-9625-5889
  • Andreia Nunes Internal Medicine Department, Hospital Garcia de Orta EPE, Almada, Portugal Author https://orcid.org/0000-0001-6743-9868
  • Clara Almeida Nephrology Department, Unidade Local de Saúde Gaia Espinho, Vila Nova de Gaia, Portugal Author
  • Inês Aires Nephrology and Transplant Unit, Hospital Curry Cabral, Unidade Local de Saúde São José, Lisboa, Portugal Author https://orcid.org/0000-0001-6451-0331
  • João Pedro Nobre USF Rodrigues Miguéis, Unidade Local de Saúde de Santa Maria, ACeS Lisboa Norte, Portugal Author https://orcid.org/0009-0002-8491-7563
  • João Sérgio Neves Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar Universitário de São João, Unidade Local de Saúde de São João, Porto, Portugal Author https://orcid.org/0000-0002-8173-8255
  • Jordana Dias Guarda Customized Healthcare Unit, ACES Guarda, Unidade Local de Saúde da Guarda, Guarda, Portugal Author
  • Miguel Bigotte Vieira Nephrology and Transplant Unit, Hospital Curry Cabral, Unidade Local de Saúde São José, Lisboa, Portugal; NOVA Medical School, Universidade Nova de Lisboa, Lisboa, Portugal Author https://orcid.org/0000-0003-0528-2716
  • Miguel Melo Endocrinology, Diabetes and Metabolism Department, Centro Hospitalar e Universitário de Coimbra, ULS Coimbra EPE, Coimbra, Portugal; Faculty of Medicine, University of Coimbra, Coimbra, Portugal Author https://orcid.org/0000-0002-8365-1380
  • Nuno Capela USF Serpa Pinto, ACeS Porto Ocidental, Unidade Local de Saúde de Santo António, Porto, Portugal Author https://orcid.org/0000-0001-9631-321X
  • Susana Heitor Internal Medicine Department, Integrated Diabetes Unit, Hospital Prof Doutor Fernando Fonseca, Unidade Local Saúde de Amadora/Sintra, Amadora, Portugal Author https://orcid.org/0000-0001-6313-6421
  • João Couceiro AstraZeneca Portugal Author https://orcid.org/0000-0003-3640-1466
  • Hugo Martinho AstraZeneca Portugal Author
  • Leonor Luz-Duarte USF Caminho Novo, Unidade Local de Saúde Gaia Espinho, VNGaia, Portugal; MTG Research and Development Lab, Porto, Portugal Author https://orcid.org/0000-0001-5116-5014
  • Tiago Taveira-Gomes MTG Research and Development Lab, Porto, Portugal; Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto (MEDCIDS‐ ‐FMUP), Porto, Portugal; Faculty of Health Sciences, Fernando Pessoa University (FCS‐UFP), Porto, Portugal; Center for Health Technology and Services Research (CINTESIS), Porto, Portugal Author https://orcid.org/0000-0002-0998-6000

Keywords:

Awareness, Consensus, Renal Insufficiency, Chronic

Abstract

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.

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Published

20-08-2024

Data Availability Statement

LLD: material preparation, data collection, statistical analysis and writing the original draft. TTG: Study design and supervision, statistical analysis and critical reviewing of the content of the article. JC, HM: Study design and supervision and critical reviewing of the content of the article. JM, FA, AN, CA, IA, JPN, JSN, JD, MBV, MM, NC, SH: critical reviewing of the content of the article.

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Copyright (c) 2024 Jorge Malheiro, Francisco Araújo, Andreia Nunes, Clara Almeida, Inês Aires, João Pedro Nobre, João Sérgio Neves, Jordana Dias, Miguel Bigotte Vieira, Miguel Melo, Nuno Capela, Susana Heitor, João Couceiro, Hugo Martinho, Leonor Luz-Duarte, Tiago Taveira-Gomes (Author)

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NAU ‐ New NAU - Areas of Unifying Interest for CKD: A Multidisciplinary Expert Opinion Using the Jandhyala Method. (2024). Portuguese Kidney Journal. https://pkj.spnefro.pt/index.php/journal/article/view/38

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