Patient Referral and Education Program Prior to Renal Replacement Therapy (PREP-RRT): A Pilot Study

TL;DR

A short inpatient education program improved kidney disease knowledge among African American patients before kidney failure treatment.

Contribution

A culturally tailored inpatient intervention increased CKD knowledge in African American patients.

Findings

CKD knowledge scores significantly improved after the intervention.

Knowledge of kidney failure treatment options increased significantly.

Patient intent to make lifestyle changes remained high but did not increase.

Abstract

African American individuals with CKD are less likely to receive early CKD education and care than their White counterparts and have a more rapid progression to kidney failure.

To determine if a brief inpatient intervention increased CKD knowledge.

Pre-post evaluation of a pilot intervention.

The PREP-RRT pilot study recruited hospitalized adult African American patients with an estimated glomerular filtration rate (GFR) ≤ 45 from a general medicine inpatient service at a Midwestern academic medical center.

A social worker provided CKD patient education and motivational interviewing for behavior change.

The primary outcome was change in patient knowledge about CKD, using the Kidney Knowledge Survey (KiKS), and kidney failure treatment options.

Out of the 60 patients, 52% were female (n = 21) with a mean age of 61 years old (range 28–76). Only 45% of patients (n = 27) had sufficient CKD knowledge at baseline. The median pre-intervention CKD knowledge score was 16 (interquartile range (IQR) 13–18) and the post-intervention score was 19 (IQR 17–21). Paired t-tests showed significant improvement in the primary outcome, CKD knowledge (p < 0.001). Overall baseline knowledge of kidney failure treatment modalities was low (< 30% with some to great knowledge for all modalities), and participants reported a significant increase in knowledge across kidney failure treatment modalities (all p < 0.05 except p = 0.17 conservative management). Patient intent to make lifestyle changes was high pre-intervention and did not change significantly.

A brief, culturally tailored inpatient intervention successfully increased knowledge of CKD and kidney failure treatment options for African American hospitalized patients. More intensive interventions are needed to sustain knowledge gains and motivation for lifestyle changes.

The online version contains supplementary material available at 10.1007/s11606-025-09699-w.

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