Review
BibTex RIS Cite

Chronic kidney disease awareness: a narrative review of patient, healthcare system, and community perspectives

Year 2026, Volume: 7 Issue: 2, 415 - 423, 27.03.2026
https://izlik.org/JA82FN24ZG

Abstract

Chronic kidney disease (CKD) affects 788 million adults worldwide and is among the leading causes of death globally, yet awareness of the disease remains critically low across all populations. This narrative review synthesises the current evidence on CKD awareness at three interconnected levels: the individual patient, the healthcare system, and the community. At the patient level, pooled estimates indicate that overall CKD awareness is approximately 19%, with awareness in general population settings as low as 7.3%. Even among patients under nephrology care, significant knowledge gaps persist regarding treatment modalities and disease progression. At the healthcare system level, studies such as the multinational REVEAL-CKD study demonstrate that over 75% of stage 3 CKD cases remain undiagnosed, with underdiagnosis rates reaching 95% in some countries. Provider-level barriers include time constraints, lack of clinical confidence, and reluctance to communicate a CKD diagnosis. At the community level, public understanding of kidney health is profoundly limited compared with awareness of other chronic conditions such as diabetes and cardiovascular disease. This review further examines the determinants of CKD awareness, including education, socioeconomic status, age, and comorbidities. Health literacy emerges as a critical mediating factor, with approximately 25% of CKD patients demonstrating limited health literacy. Current evidence on awareness-enhancing interventions, measurement tools, and national policy initiatives is also reviewed. The findings underscore the urgent need for coordinated, multilevel strategies that address individual knowledge deficits, strengthen healthcare system capacity for early detection, and enhance community-level understanding of CKD.

Ethical Statement

Ethical approval and consent to participate were waived because of the study’s narrative design.

Supporting Institution

-

Thanks

-

References

  • Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. 2024;105(4S):S117–S314. doi:10.1016/j.kint.2023.10.018
  • GBD 2023 Chronic Kidney Disease Collaborators. Global, regional, and national burden of chronic kidney disease in adults, 1990-2023, and its attributable risk factors: a systematic analysis for the Global Burden of Disease Study 2023. Lancet. 2025;406(10518):2461-2482. doi:10.1016/S0140-6736(25)01853-7
  • Francis A, Harhay MN, Ong ACM, et al. Chronic kidney disease and the global public health agenda: an international consensus. Nat Rev Nephrol. 2024;20(7):473-485. doi:10.1038/s41581-024-00820-6
  • Foreman KJ, Marquez N, Dolgert A, et al. Forecasting life expectancy, years of life lost, and all-cause and cause-specific mortality for 250 causes of death: reference and alternative scenarios for 2016-40 for 195 countries and territories. Lancet (London, England). 2018;392(10159):2052-2090. doi:10.1016/S0140-6736(18)31694-5
  • Süleymanlar G, Utaş C, Arinsoy T, et al. A population-based survey of Chronic REnal Disease In Turkey—the CREDIT study. Nephrol Dial Transplant. 2011;26(6):1862-1871. doi:10.1093/ndt/gfq656
  • Chu CD, Chen MH, McCulloch CE, et al. Patient awareness of CKD: a systematic review and meta-analysis of patient-oriented questions and study setting. Kidney Med. 2021;3(4):576-585.e1. doi:10.1016/j.xkme. 2021.03.014
  • Centers for Disease Control and Prevention. Chronic Kidney Disease in the United States, 2023. 2023. https://www.cdc.gov/kidney-disease/php/data-research/index.html
  • Sprangers B, Evenepoel P, Vanrenterghem Y. Late referral of patients with chronic kidney disease: no time to waste. Mayo Clin Proc. 2006; 81(11):1487-1494. doi:10.4065/81.11.1487
  • Navaneethan SD, Aloudat S, Singh S. A systematic review of patient and health system characteristics associated with late referral in chronic kidney disease. BMC Nephrol. 2008;9:3. doi:10.1186/1471-2369-9-3
  • Bronfenbrenner U. The ecology of human development: experiments by nature and design. Cambridge, MA: Harvard University Press. 1979.
  • Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260-272. doi:10. 1016/S0140-6736(13)60687-X
  • GBD 2023 Kidney Failure with Replacement Therapy Collaborators. Global, regional, and national prevalence of kidney failure with replacement therapy and associated aetiologies, 1990-2023: a systematic analysis for the Global Burden of Disease Study 2023. Lancet Glob Health. 2025;13(8):e1378-e1395. doi:10.1016/S2214-109X(25)00198-6
  • Turkish Society of Nephrology & Ministry of Health of Türkiye. Registry of the Nephrology, Dialysis and Transplantation in Turkey 2024. Turkish Society of Nephrology; 2025.
  • Liabeuf S, Sajjad A, Kramer A, et al. Guideline attainment and morbidity/mortality rates in a large cohort of European haemodialysis patients (EURODOPPS). Nephrol Dial Transplant. 2019;34(12):2105-2110. doi:10.1093/ndt/gfz049
  • Finkelstein FO, Story K, Firanek C, et al. Perceived knowledge among patients cared for by nephrologists about chronic kidney disease and end-stage renal disease therapies. Kidney Int. 2008;74(9):1178-1184. doi: 10.1038/ki.2008.376
  • Wright JA, Wallston KA, Elasy TA, Ikizler TA, Cavanaugh KL. Development and results of a kidney disease knowledge survey given to patients with CKD. Am J Kidney Dis. 2011;57(3):387-395. doi:10.1053/j.ajkd.2010.09.018
  • Chu CD, McCulloch CE, Banerjee T, et al. CKD awareness among US adults by future risk of kidney failure. Am J Kidney Dis. 2020;76(2):174-183. doi:10.1053/j.ajkd.2020.01.007
  • Plantinga LC, Boulware LE, Coresh J, et al. Patient awareness of chronic kidney disease: trends and predictors. Arch Intern Med. 2008;168(20): 2268-2275. doi:10.1001/archinte.168.20.2268
  • Janz NK, Becker MH. The Health Belief Model: a decade later. Health Educ Q. 1984;11(1):1-47. doi:10.1177/109019818401100101
  • Yabeyu AB, Haile KT, Belay YB, Tegegn HG. Limited public knowledge of chronic kidney disease in a resource-limited setting: a cross-sectional study. Int J Gen Med. 2022;15:4997-5003. doi:10.2147/IJGM.S364632
  • Fathy B, Se'eda H, Fayez TM, et al. Awareness of chronic kidney disease evaluated using validated questionnaire in Minia Governorate public. Egypt J Hosp Med. 2021;85(2):3985-3988. doi:10.21608/ejhm.2021.206848
  • Mahmoud MA, Ibrahim A, Fadil HA, et al. Assessment of public knowledge about chronic kidney disease and factors influencing knowledge levels: a cross-sectional study. Medicina (Kaunas). 2023; 59(12):2072. doi:10.3390/medicina59122072
  • Rashid I, Sharma S, Kamboj G, et al. Assessment of public knowledge and attitude towards chronic kidney disease. Biomed J Sci Tech Res. 2022;41(5):006662. doi:10.26717/BJSTR.2022.41.006662
  • Sham F, Ahmad A, Abd Halim M, Jamiat N. Public awareness of chronic kidney disease in Malaysia. Environment-Behaviour Proceedings J. 2025; 10(32):261-269. doi:10.21834/e-bpj.v10i32.6599
  • Gök E, Şahin MK. Chronic kidney disease awareness: a cross-sectional study in primary care settings in Turkiye. J Nephrol. 2025;38(3):979-988. doi:10.1007/s40620-025-02210-y
  • Salman MY, Utku İ, Kurtulus F. Evaluation of the awareness of chronic kidney disease among patients receiving hemodialysis. Eurasian J Crit Care. 2021;3(1):10-14.
  • Turgay G, Özdemir Eler Ç. Herkes için böbrek sağlığı. NefroHemDergi. 2023;18(3):124-133. doi:10.47565/ndthdt.2023.75
  • Braveman P, Gottlieb L. The social determinants of health: it's time to consider the causes of the causes. Public Health Rep. 2014;129(Suppl 2): 19-31. doi:10.1177/00333549141291S206
  • Sørensen K, Pelikan JM, Röthlin F, et al. Health literacy in Europe: comparative results of the European health literacy survey (HLS-EU). Eur J Public Health. 2015;25(6):1053-1058. doi:10.1093/eurpub/ckv043
  • Neter E, Brainin E. eHealth literacy: extending the digital divide to the realm of health information. J Med Internet Res. 2012;14(1):e19. doi:10. 2196/jmir.1619
  • Tangri N, Moriyama T, Schneider MP, et al. Prevalence of undiagnosed stage 3 chronic kidney disease in France, Germany, Italy, Japan and the USA: results from the multinational observational REVEAL-CKD study. BMJ Open. 2023;13(5):e067386. doi:10.1136/bmjopen-2022- 067386
  • Kushner PR, DeMeis J, Stevens P, Gjurovic AM, Malvolti E, Tangri N. Patient and clinician perspectives: to create a better future for chronic kidney disease, we need to talk about our kidneys. Adv Ther. 2024;41(4): 1318-1324. doi:10.1007/s12325-024-02794-0
  • McIntyre NJ, Fluck R, McIntyre C, Taal M. Treatment needs and diagnosis awareness in primary care patients with chronic kidney disease. Br J Gen Pract. 2012;62(597):e227-e232. doi:10.3399/bjgp12X 636047
  • Kostev K, Lang M, Tröbs SO, Urbisch S, Gabler M. The underdiagnosis of chronic kidney disease in patients with a documented estimated glomerular filtration rate and/or urine albumin-creatinine ratio in Germany. Medicina (Kaunas). 2025;61(5):843. doi:10.3390/medicina 61050843
  • Pesce F, Pasculli D, Pasculli G, et al. "The Disease Awareness Innovation Network" for chronic kidney disease identification in general practice. J Nephrol. 2022;35(8):2057-2065. doi:10.1007/s40620-022-01353-6
  • Narva AS, Norton JM, Boulware LE. Educating patients about CKD: the path to self-management and patient-centered care. Clin J Am Soc Nephrol. 2016;11(4):694-703. doi:10.2215/CJN.07680715
  • Wallace H, Daly JO, Jun M, Nelson C. Rethinking models of chronic kidney disease care: a narrative review. Kidney Blood Press Res. 2025; 50(1):433-441. doi:10.1159/000546562
  • Metsärinne K, Bodegård J, Toppila I, Uusi-Rauva K, Frederiksen LE, Brinkmann S. Characteristics, treatment and disease burden among stage 3-4 chronic kidney disease patients with and without type 2 diabetes in Finland during 2016-2022. Nephrol Dial Transplant. 2025; 40(6):1115-1123. doi:10.1093/ndt/gfae242
  • Zhuo M, Li J, Buckley LF, et al. Prescribing patterns of sodium-glucose cotransporter-2 inhibitors in patients with CKD: a cross-sectional registry analysis. Kidney360. 2022;3(3):455-464. doi:10.34067/KID. 0007862021
  • Lau D, Pannu N, Yeung RO, Scott-Douglas N, Klarenbach S. Use of sodium-glucose cotransporter 2 inhibitors in Alberta adults with chronic kidney disease: a cross-sectional study identifying care gaps to inform knowledge translation. CMAJ Open. 2023;11(1):E101-E109. doi: 10.9778/cmajo.20210281
  • Waterman AD, Browne T, Waterman BM, Gladstone EH, Hostetter T. Attitudes and behaviors of African Americans regarding early detection of kidney disease. Am J Kidney Dis 2008;51(4):554-562. doi:10.1053/j.ajkd.2007.12.020
  • Remme WJ, McMurray JJ, Rauch B, et al. Public awareness of heart failure in Europe: first results from SHAPE. Eur Heart J. 2005;26(22):2413-2421. doi:10.1093/eurheartj/ehi447
  • Shah A, Fried LF, Chen SC, et al. Associations between access to care and awareness of CKD. Am J Kidney Dis. 2012;59(3 Suppl 2):S16-S23. doi:10.1053/j.ajkd.2011.10.042
  • National Institute of Diabetes and Digestive and Kidney Diseases. National Kidney Disease Education Program. U.S. Department of Health and Human Services, National Institutes of Health. 2025. https://www.niddk.nih.gov/health-information/community-health-outreach/information-clearinghouses/nkdep
  • T.C. Sağlık Bakanlığı. Türkiye Böbrek Hastalıkları ve Kontrol Programı (2025–2030). Halk Sağlığı Genel Müdürlüğü; 2025.
  • Taylor DM, Fraser S, Dudley C, et al. Health literacy and patient outcomes in chronic kidney disease: a systematic review. Nephrol Dial Transplant. 2018;33(9):1545-1558. doi:10.1093/ndt/gfx293
  • Billany RE, Thopte A, Adenwalla SF, March DS, Burton JO, Graham-Brown MPM. Associations of health literacy with self-management behaviours and health outcomes in chronic kidney disease: a systematic review. J Nephrol. 2023;36(5):1267-1281. doi:10.1007/s40620-022-01537-0
  • Coskun S, Bagcivan G. Associated factors with treatment adherence of patients diagnosed with chronic disease: relationship with health literacy. Appl Nurs Res. 2021;57:151368. doi:10.1016/j.apnr.2020.151368
  • Jankowska-Polańska B, Uchmanowicz I, Dudek K, Mazur G. Relationship between patients' knowledge and medication adherence among patients with hypertension. Patient Prefer Adherence. 2016;10: 2437-2447. doi:10.2147/PPA.S117269
  • Heydari A, Ziaee ES, Gazrani A. Relationship between awareness of disease and adherence to therapeutic regimen among cardiac patients. Int J Community Based Nurs Midwifery. 2015;3(1):23-30.
  • Campbell ZC, Dawson JK, Kirkendall SM, et al. Interventions for improving health literacy in people with chronic kidney disease. Cochrane Database Syst Rev. 2022;12(12):CD012026. doi:10.1002/ 14651858.CD012026.pub2
  • Tuot DS, Davis E, Velasquez A, Banerjee T, Powe NR. Assessment of printed patient-educational materials for chronic kidney disease. Am J Nephrol. 2013;38(3):184-194. doi:10.1159/000354314
  • Assad Lemos C, Zago Oliveira T, Alves Cunha JP, et al. Instruments to assess diabetes knowledge, skills and attitudes of people living with diabetes mellitus: a COSMIN-based systematic review. Diabetes Metab Syndr. 2024;18(3):102974. doi:10.1016/j.dsx.2024.102974
  • Erkoc SB, Isikli B, Metintas S, Kalyoncu C. Hypertension Knowledge-Level Scale (HK-LS): a study on development, validity and reliability. Int J Environ Res Public Health. 2012;9(3):1018-1029. doi:10.3390/ijerph 9031018
  • Gerretsen P, Kim J, Shah P, et al. BASIS: the blood pressure awareness and insight scale. J Clin Hypertens (Greenwich). 2018;20(4):748-756. doi: 10.1111/jch.13248
  • Hattori A, Imaizumi T, Toda T, et al. Factors associated with awareness of chronic kidney disease, and impact of awareness on renal prognosis. Clin Exp Nephrol. 2025;29(5):596-606. doi:10.1007/s10157-024-02605-4
  • Lee YL, Lin DT, Tsai SF. Disease knowledge and treatment adherence among patients with thalassemia major and their mothers in Taiwan. J Clin Nurs. 2009;18(4):529-538. doi:10.1111/j.1365-2702.2007.02150.x
  • Evans M, Lewis RD, Morgan AR, et al. A Narrative review of chronic kidney disease in clinical practice: current challenges and future perspectives. Adv Ther. 2022;39(1):33-43. doi:10.1007/s12325-021-01927-z
  • Boonstra MD, do Amaral MSG, Navis G, et al. Effectiveness of a health literacy intervention targeting both chronic kidney disease patients and health care professionals in primary and secondary care: a quasi-experimental study. J Nephrol. 2024;37(9):2621-2633. doi:10.1007/s40620-024-02058-8
There are 59 citations in total.

Details

Primary Language English
Subjects Nefroloji, Public Health (Other)
Journal Section Review
Authors

Berrak Itır Aylı 0000-0002-0834-900X

Nüket Paksoy Erbaydar 0000-0001-8004-4342

Submission Date February 13, 2026
Acceptance Date March 9, 2026
Publication Date March 27, 2026
IZ https://izlik.org/JA82FN24ZG
Published in Issue Year 2026 Volume: 7 Issue: 2

Cite

AMA 1.Aylı BI, Paksoy Erbaydar N. Chronic kidney disease awareness: a narrative review of patient, healthcare system, and community perspectives. J Med Palliat Care / JOMPAC / jompac. 2026;7(2):415-423. https://izlik.org/JA82FN24ZG

TR DİZİN ULAKBİM and International Indexes (1d)

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS]



google-scholar.png


crossref.jpg

f9ab67f.png

asos-index.png


COPE.jpg

icmje_1_orig.png

cc.logo.large.png

ncbi.png


pn6krf5.jpg


Our journal is in TR-Dizin, DRJI (Directory of Research Journals Indexing, General Impact Factor, Google Scholar, Researchgate, CrossRef (DOI), ROAD, ASOS Index, Turk Medline Index, Eurasian Scientific Journal Index (ESJI), and Turkiye Citation Index.

EBSCO, DOAJ, OAJI and ProQuest Index are in process of evaluation. 

Journal articles are evaluated as "Double-Blind Peer Review"