Background: Survivors of acute kidney injury (AKI) are at risk of adverse outcomes. Post-discharge nephrology care may improve patients’ AKI knowledge and prevent post-AKI complications.
Objective: The purpose of this study was to examine patients’ awareness about their AKI diagnosis and self-rated knowledge and severity of AKI before and after their first post-discharge AKI Clinic encounter.
Design: We conducted a pre- and post-survey study among AKI survivors who attended a post-discharge AKI Clinic.
Setting: AKI Clinic at the University of Kentucky Medical Center (October 2016 to December 2017). Education about AKI was based on transformative learning theory and provided through printed materials and interdisciplinary interactions between patients/caregivers and nurses, pharmacists, and nephrologists.
Patients: A total of 104 patients completed the survey and were included in the analysis.
Measurements: Three survey questions were administered before and after the first AKI Clinic encounter: Question 1 (yes-no) for awareness, and questions 2 and 3 (Likert scale, 1 = lowest to 5 = highest) for self-rated knowledge and severity of AKI.
Methods: Two mixed-model analysis of variance (ANOVA) was used for between-group (AKI severity) and within-group (pre- and post-encounter) comparisons. Logistic regression was used to examine parameters associated with the within-group change in self-perceived knowledge.
Results: Twenty-two out of 104 (21%) patients were not aware of their AKI diagnosis before the clinic encounter. Patients’ self-ratings of their AKI knowledge significantly increased after the first AKI Clinic encounter (mean ± SEM: pre-visit = 1.94 ± 0.12 to post-visit = 3.88 ± 0.09, P = .001), even after adjustment for age, gender, Kidney Disease Improving Global Outcomes (KDIGO) severity stage, or poverty level. Patients with AKI stage 3 self-rated their AKI as more severe than patients with AKI stage 1 or 2.
Limitations: Our study population may not be representative of the general AKI survivor population. Administered surveys are subject to response-shift bias.
Conclusions: Patients’ self-perceived knowledge about AKI significantly increased following the first post-discharge AKI Clinic encounter that included interdisciplinary education. This is the first survey study examining self-perceived AKI knowledge in AKI survivors. Further examination of AKI literacy in survivors of AKI and its effect on post-AKI outcomes is needed.
Trial registration: Not applicable.
Digital Object Identifier (DOI)
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr Neyra is supported by an Early Career Pilot Grant from the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant UL1TR001998 and the Kentucky Nephrology Research Trust. Dr. Alcorn was supported through Grant T32DA07304.
Data and materials may be made available upon written request to the corresponding author.
Supplemental material for this article is available online.
Ortiz-Soriano, Victor M.; Alcorn, Joseph L. III; Li, Xilong; Elias, Madona; Ayach, Taha; Sawaya, B. Peter; Malluche, Hartmut H.; Wald, Ron; Silver, Samuel A.; and Neyra, Javier A., "A Survey Study of Self-Rated Patients' Knowledge About AKI in a Post-Discharge AKI Clinic" (2019). Internal Medicine Faculty Publications. 203.