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Effect of Kidney Disease Education on Kidney Disease Screening Uptake among Adults in Nigeria

Abstract

Kidney disease is an important public health concern because undetected kidney damage may progress gradually and eventually lead to serious complications, including chronic kidney disease, cardiovascular complications, kidney failure, and premature death. Early identification of individuals at risk can support timely clinical assessment, appropriate management, and prevention or slowing of disease progression. Kidney disease education provides adults with information about kidney function, common kidney diseases, risk factors such as hypertension and diabetes, warning signs, preventive behaviours, the importance of routine health assessment, available kidney disease screening procedures, and appropriate healthcare-seeking pathways. Kidney disease screening uptake refers to the extent to which eligible adults participate in recommended screening or assessment for kidney disease and associated risk factors through appropriate healthcare facilities. In Nigeria, inadequate kidney disease screening uptake may be associated with limited awareness, misconceptions about kidney disease, perceived absence of symptoms, financial constraints, limited access to healthcare facilities, fear of diagnosis, and inadequate knowledge of the benefits of early detection. Effective kidney disease education may improve adults' understanding of kidney disease and encourage appropriate utilization of available screening services. Against this background, this study investigates the effect of kidney disease education on kidney disease screening uptake among adults in Nigeria. The study is anchored on the Health Belief Model, Social Cognitive Theory, and the Knowledge-Attitude-Practice framework. The Health Belief Model provides a framework for understanding adults' decisions to undergo kidney disease screening through perceived susceptibility to kidney disease, perceived severity of possible complications, perceived benefits of early detection, perceived barriers to screening, and cues to action. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, social influences, environmental conditions, and health-related behaviour in shaping screening practices. The Knowledge-Attitude-Practice framework provides a basis for examining how kidney disease education may improve knowledge and attitudes and influence screening uptake. Collectively, these theoretical perspectives provide a suitable framework for explaining how kidney disease education may influence kidney disease screening uptake among adults in Nigeria. The study will adopt a quantitative quasi-experimental research design. Primary data will be collected from adults in selected communities, workplaces, primary healthcare centres, and other appropriate settings in Nigeria using a structured interviewer-administered questionnaire, kidney disease knowledge assessment, and kidney disease screening uptake assessment tool. A multistage sampling technique will be employed to select states, local government areas, communities, households, healthcare facilities, and eligible adult participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Adults in the intervention group will receive structured kidney disease education covering kidney function, common kidney diseases, major risk factors, the relationship between hypertension, diabetes and kidney disease, warning signs, preventive health behaviours, the importance of routine health assessment, available kidney disease screening procedures, and appropriate healthcare-seeking pathways. Kidney disease screening uptake will be assessed using indicators such as participation in recommended kidney health assessments, blood pressure assessment, blood glucose assessment where relevant, urine testing, serum creatinine or estimated kidney function assessment where clinically indicated, attendance for follow-up evaluation, and completion of recommended referrals. Screening participation will preferably be verified through healthcare or screening records where available. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, previous exposure to kidney health education, kidney disease knowledge, risk factors, and screening uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and logistic or multiple regression analysis, will be used to determine the effect of kidney disease education on screening uptake. Where appropriate, screening uptake before and after the intervention will be compared. Diagnostic tests will also be conducted to assess the reliability of the research instruments, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that kidney disease education has a significant positive effect on kidney disease screening uptake among adults in Nigeria. Adults exposed to structured kidney disease education are expected to demonstrate improved knowledge of kidney disease, its risk factors, the importance of early detection, and available screening options. Increased awareness is expected to encourage adults, particularly those with recognized risk factors, to participate in appropriate kidney health assessments and seek professional medical evaluation when necessary. Education may also correct the misconception that kidney disease is always accompanied by obvious symptoms and may increase understanding of the importance of screening for individuals at increased risk. However, education alone may not guarantee screening uptake because adults may continue to experience barriers such as screening costs, limited availability of healthcare facilities, geographical distance, transportation difficulties, fear of diagnosis, inadequate health insurance coverage, and competing health priorities. Consequently, kidney disease education may be most effective when supported by affordable and accessible screening services, community-based health programmes, appropriate referral systems, and sustained public health education. The study is expected to contribute to the literature on kidney disease education, kidney disease screening, chronic disease prevention, health education, health-seeking behaviour, non-communicable disease prevention, renal health, and public health in Nigeria by providing empirical evidence on the effect of kidney disease education on screening uptake among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, state ministries of health, hospitals, primary healthcare centres, nephrology and renal-care services, public health practitioners, health educators, community health workers, development partners, and policymakers regarding strategies for improving early identification of kidney disease. The study will also provide evidence-based recommendations for integrating kidney disease education into primary healthcare and community health programmes, strengthening routine risk assessment, expanding accessible screening opportunities, improving referral and follow-up systems, increasing awareness of kidney disease risk factors, and promoting timely kidney health assessment among adults in Nigeria.

Keywords: Kidney disease education, kidney disease screening uptake, adults, Nigeria, kidney health, chronic kidney disease, renal health, kidney disease screening, health education, non-communicable diseases, health-seeking behaviour, early detection, disease prevention, public health.