A Cross sectional Study of the Knowledge and Practice Patterns of Family Medicine Residents Regarding Chronic Kidney Disease Screening

Abstract

Background: The postgraduate training in medicine is aimed at equipping the trainee with the necessary skills to practice as an expert. The family physician (FP) is usually the first contact between the patient and the health care system. As such, it becomes imperative to assess the FP trainees' knowledge and practice with regards to chronic kidney disease (CKD)

Patients and Methods: Self-administered questionnaires were distributed to physicians attending a nationally organized continuing medical education workshop for resident doctors preparing for the part I and part II exit examinations of the National Postgraduate Medical College of Nigerian in the specialty of Family Medicine.

Results: Seventy six (20 senior residents and 56 junior residents) of the 150 physicians surveyed returned completed questionnaires. Only nine (11.7%) correctly identified CKD as occurring in approximately one in every ten individuals. CKD risk factors correctly identified by the respondents included: hypertension (97.4%), diabetes mellitus (94.4%), human immunodeficiency virus infection (75%), autoimmune diseases (51.3%), cancer (34.2%), advanced age (26.3%) and lower socioeconomic status (22.4%). Urinalysis and estimation of the GFR using prediction equations were correctly recognized as screening modalities for CKD by 72 (94.7%) and 71 (93.4%) respondents respectively. The majority (54.7%) considered proteinuria as significant when it is 2+. Four (5.3%) physicians “Always” screen for CKD risk factors when consulting a patient; 10 (13.3%) “Most times”; 48 (64%) “Sometimes”; 12 (16%) “Occasionally” and one (1.3%) “Never”.

Conclusion: The overall knowledge of CKD prevalence among Nigerian FP trainees attending a workshop is poor; however the knowledge regarding CKD screening is adequate. There exists a gap between CKD screening knowledge and the practice patterns of these physicians.

Key words: Chronic kidney disease; Family medicine, Residents, Screening