PDF(Pubmed)
Abstract：
One in seven adults in the United States has chronic kidney disease (CKD) and individuals with the most severe form, end stage kidney disease (ESKD), may require renal replacement therapy with hemodialysis. Despite well-established guidelines indicating that arteriovenous access is the preferred type of vascular access for hemodialysis, in 2021, 85.4% of patients initiated dialysis with a CVC. While the reasons for this evidence-practice gap are unclear, health literacy and patient disease-specific knowledge may play an important role. Importantly, 25% of patients with CKD have limited health literacy. While there is an abundance of research regarding the presence of poor health literacy, poor kidney disease-specific knowledge, and their association with health outcomes in patients with CKD, there is currently a paucity of data about the relationship between health literacy, vascular access-specific knowledge, and vascular access outcomes. The aim of this narrative review is to describe the relationship between health literacy, disease-specific knowledge, and vascular access in patients with CKD. A better understanding of health literacy in this population will help inform the development of strategies to assess patient vascular access-specific knowledge and aid in vascular access decision making.
摘要：
在美国，七分之一的成年人患有慢性肾病（CKD）和最严重形式的个体，终末期肾病（ESKD），可能需要血液透析的肾脏替代疗法。尽管有完善的指南表明动静脉通路是血液透析的首选血管通路，2021年，85.4%的患者开始使用CVC进行透析。虽然这种证据-实践差距的原因尚不清楚，健康素养和患者特定疾病知识可能起着重要作用。重要的是,25%的CKD患者的健康素养有限。虽然有大量关于健康素养差的研究，缺乏肾脏疾病特异性知识，以及它们与CKD患者健康结果的关系，目前缺乏关于健康素养之间关系的数据，血管通路特异性知识，和血管通路结果。这篇叙述性综述的目的是描述健康素养之间的关系，疾病特异性知识，CKD患者的血管通路。更好地了解该人群的健康素养将有助于制定评估患者血管通路特定知识的策略，并有助于血管通路决策。
