Kidney medicine · 2025
Reproductive Health Knowledge and Educational Priorities in Chronic Kidney Disease: A Cross-Sectional Survey of People With CKD.
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Darpel Kelcie K, Wright-Nunes Julie A, Hawley Sarah T, Hladunewich Michelle A, Kalpakjian Claire Z, Powell Corey, Oliverio Andrea L
Аннотация
RATIONALE & OBJECTIVE: Female reproductive health is affected by kidney disease but is often not addressed in nephrology care. Our objective was to better understand patient education needs on this topic to facilitate reproductive health education and care in chronic kidney disease (CKD).
STUDY DESIGN: A cross-sectional online survey.
SETTING & PARTICIPANTS: Female assigned sex at birth, aged 18-45 years, within the United States, fluent in English, with CKD recruited from national kidney organizations, research consortiums, and an academic medical center.
OUTCOMES: Reproductive health knowledge satisfaction, education needs, and communication preferences and barriers.
EXPOSURES: Gravidity, pregnancy planning, CKD stage, disease etiology, health literacy, and demographics.
ANALYTIC APPROACH: Univariate and multivariable logistic regression were used to examine associations between patient characteristics, knowledge satisfaction, and education needs. Descriptive statistics were used to assess communication preferences and barriers.
RESULTS: Two hundred and nine surveys were completed. In total, 77% of participants self-identified as White, 11% Black, 4% Asian, and 11% Hispanic. A total of 23% had limited health literacy. Individuals planning a pregnancy in the future had lower knowledge satisfaction in univariate analysis. After multivariable analysis, only health literacy was significantly associated with knowledge satisfaction (β, -0.5; 95% CI, -0.9 to -0.02; P = 0.04). Understanding the impact of CKD on fetal development and menstruation, and kidney function changes after pregnancy were topics ranked as high priority by patients. Most wanted a nephrologist's recommendation about birth control (76%; n = 159/209) and pregnancy timing (77%; n = 161/209).
LIMITATIONS: The limitations include convenience sampling and generalizability because of the online delivery of the survey and overrepresentation of higher socioeconomic groups.
CONCLUSIONS: This study provides priority topics to include in pregnancy planning during CKD care. Patients want advice from their nephrologists. More tools are needed to support reproductive health education for people with CKD, starting by addressing the need for those with limited health literacy.
STUDY DESIGN: A cross-sectional online survey.
SETTING & PARTICIPANTS: Female assigned sex at birth, aged 18-45 years, within the United States, fluent in English, with CKD recruited from national kidney organizations, research consortiums, and an academic medical center.
OUTCOMES: Reproductive health knowledge satisfaction, education needs, and communication preferences and barriers.
EXPOSURES: Gravidity, pregnancy planning, CKD stage, disease etiology, health literacy, and demographics.
ANALYTIC APPROACH: Univariate and multivariable logistic regression were used to examine associations between patient characteristics, knowledge satisfaction, and education needs. Descriptive statistics were used to assess communication preferences and barriers.
RESULTS: Two hundred and nine surveys were completed. In total, 77% of participants self-identified as White, 11% Black, 4% Asian, and 11% Hispanic. A total of 23% had limited health literacy. Individuals planning a pregnancy in the future had lower knowledge satisfaction in univariate analysis. After multivariable analysis, only health literacy was significantly associated with knowledge satisfaction (β, -0.5; 95% CI, -0.9 to -0.02; P = 0.04). Understanding the impact of CKD on fetal development and menstruation, and kidney function changes after pregnancy were topics ranked as high priority by patients. Most wanted a nephrologist's recommendation about birth control (76%; n = 159/209) and pregnancy timing (77%; n = 161/209).
LIMITATIONS: The limitations include convenience sampling and generalizability because of the online delivery of the survey and overrepresentation of higher socioeconomic groups.
CONCLUSIONS: This study provides priority topics to include in pregnancy planning during CKD care. Patients want advice from their nephrologists. More tools are needed to support reproductive health education for people with CKD, starting by addressing the need for those with limited health literacy.