3 Don’t label ageing as disease: the kidney age communication tool

BMJ Evidence-Based Medicine(2019)

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摘要
Objectives Previous research shows that the terminology ‘chronic kidney disease’ (CKD) is problematic for both patients and general practitioners, arguably because it represents an ageing process rather than a disease. We have previously proposed an alternative terminology ‘kidney age’ to supersede the terminology of CKD stages 2, 3a, 3b and 4. We aim to develop a communication tool that can be used to discuss declining kidney function with patients without using the terminology of ‘disease’. Method We used electronic health record data from UK primary care to design a prototype communication aid: a table and explanatory text showing how eGFR values map to bands of ‘kidney age’, and the increasing CVD risk at each band of kidney age. The design and content were refined iteratively in consultation with patient-public involvement representatives. UK general practitioners were then interviewed about the proposed design and content. Results Interviews are ongoing but results to date suggest that GPs would welcome ‘kidney age’ terminology and our communication tool, possibly modified, as a potential intervention. Conclusions A web-based version of the communication aid is currently under development, that can be tested as an intervention in a future parallel-group trial.
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