Family-based screening for polycystic kidney disease: the role of health literacy.

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disorder globally, and early identification of affected family members is essential. The goal of this study was to investigate family screening uptake among relatives of ADPKD patients and to identify patient-level factors affecting screening.

METHODS: This cross-sectional study was conducted at Etlik City Hospital, Ankara, with the approval of the local ethics committee. Sociodemographic data, clinical parameters, and family screening outcomes were collected, and health literacy was assessed using Türkiye Sağlık Okuryazarlığı Ölçeği-32 (TSÖY-32). Screening outcomes were defined as relatives who had been screened, expressed willingness to be screened, and refused screening. Analyses included descriptive statistics, Spearman correlations, chi-square tests, binary logistic regression, interaction modeling, and fractional logistic regression.

RESULTS: Among 395 relatives of 68 patients, 234 (59%) had been screened, 56 (14%) expressed willingness, and 105 (27%) declined. Higher health literacy (TSÖY-32) scores correlated with greater screening uptake (ρ = 0.77, P < .001). In multivariable logistic regression, TSÖY-32 was the only independent predictor (odds ratio [OR] 1.26, 95% confidence interval [CI] 1.07-1.49, P = .005). Each 1-point increase in TSÖY-32 was associated with a 14% increase in screening odds (OR 1.14, 95% CI 1.09-1.20, P < .001).

CONCLUSION: Family screening uptake remains suboptimal. Health literacy was the strongest predictor of screening. Interventions incorporating health literacy assessment, patient-centered counseling, and systematic screening opportunities are needed.