Reproductive Health Knowledge and Educational Priorities in Chronic Kidney Disease: A Cross-Sectional Survey of People With CKD
Bibliographic record
Abstract
Rationale & Objective Female reproductive health is affected by kidney disease but is often not addressed in nephrology care. Our objective was to better understand patient education needs on this topic to facilitate reproductive health education and care in chronic kidney disease (CKD). Study Design A cross-sectional online survey. Setting & Participants Female assigned sex at birth, aged 18-45 years, within the United States, fluent in English, with CKD recruited from national kidney organizations, research consortiums, and an academic medical center. Outcomes Reproductive health knowledge satisfaction, education needs, and communication preferences and barriers. Exposures Gravidity, pregnancy planning, CKD stage, disease etiology, health literacy, and demographics. Analytic Approach Univariate and multivariable logistic regression were used to examine associations between patient characteristics, knowledge satisfaction, and education needs. Descriptive statistics were used to assess communication preferences and barriers. Results Two hundred and nine surveys were completed. In total, 77% of participants self-identified as White, 11% Black, 4% Asian, and 11% Hispanic. A total of 23% had limited health literacy. Individuals planning a pregnancy in the future had lower knowledge satisfaction in univariate analysis. After multivariable analysis, only health literacy was significantly associated with knowledge satisfaction ( β , −0.5; 95% CI, −0.9 to −0.02; P = 0.04). Understanding the impact of CKD on fetal development and menstruation, and kidney function changes after pregnancy were topics ranked as high priority by patients. Most wanted a nephrologist's recommendation about birth control (76%; n=159/209) and pregnancy timing (77%; n=161/209). Limitations The limitations include convenience sampling and generalizability because of the online delivery of the survey and overrepresentation of higher socioeconomic groups. Conclusions This study provides priority topics to include in pregnancy planning during CKD care. Patients want advice from their nephrologists. More tools are needed to support reproductive health education for people with CKD, starting by addressing the need for those with limited health literacy. Plain-language Summary Chronic kidney disease (CKD) presents reproductive health challenges that can affect both the mother and fetus. Our study surveyed 209 women with CKD to assess their current reproductive health knowledge satisfaction, educational needs, and communication preferences and barriers. Results revealed that women are not satisfied with their knowledge about the effects of CKD on reproductive health, especially for those planning pregnancies or with low health literacy. Opportunities for nephrologists to help counsel patients on reproductive health include the effect of CKD on fetal development and disease progression after pregnancy. Despite some communication barriers, patients are open to nephrologist recommendation on reproductive health. Educational tools and nephrologist-patient discussions could improve shared decision making and improve reproductive outcomes for CKD patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".