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

Autores

  • 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 Autor https://orcid.org/0000-0002-9625-5889
  • Francisco Araújo Internal Medicine Department, Hospital Lusíadas, Lisbon, Portugal Autor https://orcid.org/0000-0002-9625-5889
  • Andreia Nunes Internal Medicine Department, Hospital Garcia de Orta EPE, Almada, Portugal Autor https://orcid.org/0000-0001-6743-9868
  • Clara Almeida Nephrology Department, Unidade Local de Saúde Gaia Espinho, Vila Nova de Gaia, Portugal Autor
  • Inês Aires Nephrology and Transplant Unit, Hospital Curry Cabral, Unidade Local de Saúde São José, Lisboa, Portugal Autor https://orcid.org/0000-0001-6451-0331
  • João Pedro Nobre USF Rodrigues Miguéis, Unidade Local de Saúde de Santa Maria, ACeS Lisboa Norte, Portugal Autor 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 Autor https://orcid.org/0000-0002-8173-8255
  • Jordana Dias Guarda Customized Healthcare Unit, ACES Guarda, Unidade Local de Saúde da Guarda, Guarda, Portugal Autor
  • 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 Autor 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 Autor https://orcid.org/0000-0002-8365-1380
  • Nuno Capela USF Serpa Pinto, ACeS Porto Ocidental, Unidade Local de Saúde de Santo António, Porto, Portugal Autor 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 Autor https://orcid.org/0000-0001-6313-6421
  • João Couceiro AstraZeneca Portugal Autor https://orcid.org/0000-0003-3640-1466
  • Hugo Martinho AstraZeneca Portugal Autor
  • Leonor Luz-Duarte USF Caminho Novo, Unidade Local de Saúde Gaia Espinho, VNGaia, Portugal; MTG Research and Development Lab, Porto, Portugal Autor 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 Autor https://orcid.org/0000-0002-0998-6000

DOI:

https://doi.org/10.71749/pkj.38

Palavras-chave:

Awareness, Consensus, Renal Insufficiency, Chronic

Resumo

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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Publicado

2024-08-20

Declaração de Disponibilidade de Dados Científicos

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.

Edição

In Press

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Original Article

Licença

Direitos de Autor (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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Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição-NãoComercial 4.0.

Como Citar

NAU ‐ New NAU - Areas of Unifying Interest for CKD: A Multidisciplinary Expert Opinion Using the Jandhyala Method. (2024). Revista Portuguesa De Nefrologia. https://doi.org/10.71749/pkj.38

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