NAU - New Areas of Unifying interest for CKD. A multidisciplinary expert opinion using the Jandhyala method (Preprint)

Abstract

The global prevalence of Chronic Kidney Disease (CKD) is rising exponentially, although its real prevalence is underestimated. We aimed to identify which areas related to CKD should be the subject of educational or research programs.

The main goal of this study is to identify which areas related to CKD should be the subject of educational or research programs.

Participants with experience in scientific production and who consider CKD as an area of interest were recruited (44 from primary care and 52 from secondary care) and divided into two groups. In the Awareness Round they answered four open short-answer questions leading to statements and in the Consensus Round they were asked to rate their level of agreement with the statements using a five-point Likert scale - the Jandhyala method.

In general, the results showed a low awareness of some entities, such as Polycystic kidney disease, glomerulopathies and acute kidney disease. Referral was the item where there was a lower consensus index, especially in primary care. Awareness and therapeutic inertia had a high awareness and consensus indexes, which represented a recognition of sometimes inadequate perception of the problem by colleagues and failure to apply appropriate diagnostic measures. The prescription of nephroprotective drugs, the avoidance of nephrotoxic drugs and referral had a low awareness index and a higher consensus and Index Score, while in secondary care, their index score was much lower.

There is a need to advocate for equitable and affordable access to the entire spectrum of kidney care everywhere and more studies to assess and reassess cost-effectiveness of screening and treatment of CKD in the light of new therapeutics. Based on our results, there is a high likelihood of success in implementing outreach projects or initiatives focused on CKD literacy, referral and disease management.