Physicians' Knowledge, Attitudes and Barriers Regarding Chronic Kidney Disease Diagnosis and Management in Saudi Arabia

Naweed Al-Zaman; Alaa Alem; Ohood A Alharbi; Ebtesam Ahmed Abdullah; Duha W Azouni; Raghad K Hammad; Reem M Alhejaily; Muayad Albadrani

doi:10.7759/cureus.50247

Physicians' Knowledge, Attitudes and Barriers Regarding Chronic Kidney Disease Diagnosis and Management in Saudi Arabia

Cureus. 2023 Dec 9;15(12):e50247. doi: 10.7759/cureus.50247. eCollection 2023 Dec.

Authors

Naweed Al-Zaman¹, Alaa Alem¹, Ohood A Alharbi², Ebtesam Ahmed Abdullah², Duha W Azouni², Raghad K Hammad², Reem M Alhejaily², Muayad Albadrani³

Affiliations

¹ Internal Medicine, College of Medicine, Taibah University, Medina, SAU.
² Medicine, College of Medicine, Taibah University, Medina, SAU.
³ Family and Community Medicine, College of Medicine, Taibah University, Medina, SAU.

Abstract

Background: Chronic kidney disease (CKD) is defined as abnormalities of kidney structure and/or function persisting for a minimum of three months.

Methods: An online cross-sectional study was conducted in the Kingdom of Saudi Arabia (KSA) between June and August 2022 to assess the knowledge, attitudes, practices, and barriers among family, internal medicine, and general physicians related to CKD screening, diagnosis, and management.

Results: A total of 427 physicians were included in the study. The majority exhibited a strong grasp of the accurate definition of CKD (83%) and recognized common risk factors, such as diabetes (99%), drugs (95%), and hypertension (98%). Two-thirds of physicians were aware of the five stages of CKD and identified estimated glomerular filtration rate (eGFR) and creatinine clearance as the most suitable markers for kidney function. Physicians also displayed knowledge of CKD-related complications. However, a noticeable gap between knowledge and practice was evident. Only one-third of participants reported screening their patients every year, primarily using serum creatinine (92.5%) and eGFR (97%) for diagnosis, while only 16% recognized that stage 4 CKD is the appropriate time to refer patients to nephrologists. In terms of barriers, the majority of physicians reported encountering low barriers to CKD management, but general practitioners working in primary healthcare centers experienced significantly higher levels of barriers.

Conclusion: Most participants in our study possess a good level of knowledge and positive attitudes towards CKD diagnosis and management. Nevertheless, a discrepancy between knowledge and practical application, particularly in terms of over-screening and early referral, highlights the need for educational efforts to improve physician practice in KSA. These findings underscore the importance of addressing this gap to promote effective CKD management.

Keywords: chronic kidney disease; family medicine; general practitioners; internal medicine; physicians' barriers; physicians' knowledge; physicians' practice; saudi arabia.