(PC228) Association between perceived and objective kidney knowledge and timing of initial vascular access consultation

Objectives: In patients with chronic kidney disease (CKD), higher kidney disease-specific knowledge is associated with improved patient satisfaction, more robust provider communication, and better patient self-management of CKD (e.g. medication and diet adherence). However, whether there are differences in kidney disease-specific knowledge among patients on or approaching dialysis at the time of arteriovenous vascular access (AVA) referral remains unclear. The objective of this study is to determine the association between kidney disease-specific knowledge and dialysis status at AVA consultation.

Methods: We conducted a prospective, cross-sectional survey of Veterans on or nearing dialysis referred to a single center vascular surgery clinic for initial AVA consultation. Participants were consecutively enrolled between July 2022-July 2023. Validated perceived (9-item Likert scale) and objective (% correct of 28-items) kidney knowledge surveys were administered. Low perceived knowledge was considered if 1 (“I don’t know anything”) or 2 (“I know a little amount) were selected on a scale of 4. Baseline sociodemographic data were collected. Descriptive statistics were calculated as mean and standard deviation (SD) or median and interquartile range (IQR) for continuous variables and frequency (%) for categorical variables.

Results: Among 61 Veterans who completed surveys, mean (SD) age was 65.5 (9.7), 98.4% were male, and 85.2% were Black. A total of 36 (59%) Veterans were pre-dialysis and 25 (41%) were already on dialysis. Of those already on dialysis, 84% utilized a central venous catheter. There were no statistically significant differences in age, sex, race, educational attainment, or income between groups. Median (IQR) perceived and objective kidney knowledge scores were 2.6 (1.9-3.1) and 20 out of 28 (18-22) for pre-dialysis participants and 2.3 (2.0-2.8) and 20 out of 28 (19-22) for participants on dialysis, respectively. In comparison to pre-dialysis patients, 68% (vs 44.4%) of patients on dialysis reported low perceived knowledge about how kidney function is checked by a doctor. There were no statistically significant differences in perceived (p=0.51) or objective (p=0.33) kidney knowledge scores. Most participants did not know chronic kidney disease may have no symptoms (80.3%) and had low perceived knowledge about medications that could help (78.7%) or hurt (82.0%) the kidney.

Conclusions: Among patients referred for initial AVA consultation, there is no difference in kidney disease knowledge for those already on or approaching dialysis. The overall poor perceived and objective knowledge reported by Veterans highlights the need for improved communication and education both before and during dialysis care.