Slowing the progression of chronic kidney disease: Comparison between predialysis and dialysis Jordanian patients

Clinical Nursing Department, College of Nursing-University of Jordan , Amman , Jordan.
Renal Failure (Impact Factor: 0.94). 09/2013; 35(10). DOI: 10.3109/0886022X.2013.828260
Source: PubMed


The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) has increased worldwide; however, data regarding the prevalence of CKD in Jordan are limited. Therefore, the present study investigated the associated risk factors of both CKD and ESRD in Jordanian patients.

A convenience sample of 161 patients with CKD (n = 92) and ESRD (n = 69) was recruited through randomly selected hospitals from the governmental, private and educational sectors in Jordan. A sociodemographic data and behavioral variables (exercise frequency per week, body mass index, and smoking status) were collected and compared between the two groups to obtain the needed information.

ESRD in amounted to relatively 68% in males and 52% in the unmarried patients (p = 0.01). In addition, patients with poor physical activity were more likely to be on the postdialysis phase. Patients with ESRD were characterized with low BMI when compared with patients CKD (t = 3.1, p = 0.004).

National CKD and ESRD risk assessment is important in considering primary prevention for CKD progression. At the front line in health care, the nurse can play a vital role in assessing patient's risk for renal disease progression.

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    • "Hypertension and diabetes mellitus are the leading important risk factors for CKD in developing countries. Many studies have confirmed this association due to the fact that these two diseases share risk factors such as smoking and obesity, and promote vascular alterations that increase the risk for developing kidney impairment (Alramly et al. 2013). Globally , the prevalence of hypertension in adults was estimated to be about 26%, most cases (66%) being in developing countries (Ibrahim & Damasceno 2012). "
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    ABSTRACT: To describe the knowledge, attitudes and practices of Jordanian patients with chronic illnesses towards prevention and early detection of chronic kidney disease. Patients with chronic illnesses such as hypertension and diabetes need to adopt healthy attitudes and practices and gain knowledge regarding prevention and early detection of kidney disease to decrease the prevalence of dialysis-related complications and costs. A total of 740 patients were recruited from out-patients clinics in Jordan. Knowledge, attitudes and practices about kidney disease prevention and early detection were measured using the Chronic Kidney Disease Screening Index which was developed by the researcher and tested for validity and reliability. The results revealed that most of the participants have knowledge about kidney disease; however, half of them had wrong information related to signs and symptoms of chronic kidney disease. The majority of the participants were not aware about the importance of discovering health problems at early stages. Improvement in population understanding about chronic kidney disease is needed to advance their awareness and practices to make appropriate decisions towards health promotion and better quality of life. Nurses need to be involved in development of protocols for screening and intervention programmes, taking into consideration the cultural issues and the financial status of individuals at risk for kidney disease. Governments should adopt a public health policy for chronic kidney disease that supports programmes for screening and programmes for improving public awareness for kidney disease prevention.
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    ABSTRACT: Objective: Public understanding of chronic kidney disease (CKD) is important to ensure informed participation in CKD prevention programs. This study aimed to develop and to test the psychometric profile of the CKD Screening Index that measures patient's knowledge, attitudes, and practices regarding CKD prevention and early detection. Methods: A cross-sectional design was implemented and a total of 740 Jordanian patients recognized at risk for CKD were recruited by convenience sampling from out-patient departments. Development and psychometric validation of the CKD Screening Index were conducted in four phases: (1) item generation, (2) pilot study, (3) preliminary psychometric validation study to examine factor structure, and (4) final psychometric validation with 740 participants. Results: On factor analysis, 24 items categorical knowledge items loaded into one factor and yielded a Guttman Split-Half Coefficient of 0.80. In a separate factor analysis, 15 items were loaded on two attitude factors (Cronbach alpha coefficient = 0.69), and nine items loaded on two practice factors (Cronbach alpha coefficient = 0.68). The CKD Screening Index associated significantly and negatively with depressed and anxious patients compared to their counterparts. Practice implications: This promising CKD Screening Index can be used for an early identification of patients at risk for CKD, thus, allowing the development of interventions to raise these patients' awareness. Future studies are needed on other populations with different cultural background to support reliability and validity of this new instrument.
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    ABSTRACT: PurposeTo explore Jordanian chronic illnesses patients' perceived exercise self-efficacy, benefits and barriers, and commitment to exercise planning, and to assess the relationship between those variables.DesignDescriptive cross-sectional design.Methods Data were collected from a convenience sample of 402 outpatient Jordanians with chronic illnesses, using Exercise Self-Efficacy Scale, Exercise Benefits and Barriers Scale, and Commitment to a Plan for Exercise Scale.FindingsThe average BMI was 28.3, and exercise period 3.2 hours/ week. Participants reported moderate perceived self-efficacy (M= 47.5%, SD= 11.7), commitment to exercise planning (M=2.0/3, SD=0.3), exercise barriers (M=2.4/4, SD=0.3), and benefits (M=2.3/4, SD=0.3). Commitment to exercise planning had a significant correlation with barriers (r=0.11) and benefits (r=0.10). Self-efficacy was not found to correlate with other variables.Conclusions Even though participants reported higher perceived self-efficacy and commitment to exercise plan than that reported in literature, they were found to be overweight and inactive, which indicates the importance of such study. Exercise education programs are needed taking into considerations patients' individual differences. However, the broad grouping of diseases may not produce a homogenous sample, for which disease categories are recommended in future studies.Clinical RelevancePatients with chronic illness need more encouragement to engage themselves in exercise practices. Exercise educational program for patients with chronic illnesses should consider patients' reported exercise benefits and barriers.
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