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Impact of Chronic Kidney Disease Education on Kidney Disease Screening Uptake among Adults in Nigeria

Abstract

Chronic kidney disease (CKD) is an important public health concern in Nigeria and is associated with substantial morbidity, mortality, reduced quality of life, and increasing healthcare costs. Early detection through appropriate screening can help identify individuals with impaired kidney function or increased risk of kidney disease and facilitate timely clinical assessment and management. Chronic kidney disease education provides adults with information about CKD, its risk factors, warning signs, complications, prevention, available screening services, and the importance of early detection. Kidney disease screening uptake refers to the utilization of appropriate screening or assessment services for kidney disease, particularly among adults who may be at increased risk. In Nigeria, inadequate awareness, misconceptions about kidney disease, low perceived risk among individuals without symptoms, limited knowledge of screening services, financial constraints, and inadequate access to healthcare facilities may contribute to low screening uptake. Effective CKD education may improve knowledge, perceived risk, awareness of the benefits of early detection, and willingness to participate in appropriate kidney disease screening. Against this background, this study investigates the impact of chronic 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 Knowledge-Attitude-Practice framework. The Health Belief Model explains preventive health behaviour through perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and cues to action, providing a basis for understanding adults' decisions to participate in kidney disease screening. Social Cognitive Theory emphasizes the interaction between knowledge, self-efficacy, behavioural capabilities, social influences, and environmental conditions in shaping preventive health behaviours. The Knowledge-Attitude-Practice framework provides a basis for examining how improved knowledge and attitudes resulting from CKD education may influence kidney disease screening practices. Collectively, these theoretical perspectives provide a suitable framework for explaining how CKD 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 facilities, and other appropriate healthcare settings in Nigeria using a structured interviewer-administered questionnaire and appropriate screening procedures. A multistage sampling technique will be employed to select states, local government areas, communities, healthcare facilities, and eligible participants. Where feasible, selected communities or participant groups will be assigned to intervention and comparison groups. Participants in the intervention group will receive structured CKD education covering the meaning of chronic kidney disease, major risk factors, including hypertension and diabetes, warning signs, possible complications, preventive measures, the importance of regular kidney health assessment, available screening services, and appropriate healthcare-seeking practices. Kidney disease screening uptake will be assessed based on participants' previous history of kidney health assessment, recent participation in appropriate screening, willingness to undergo screening, and completion of recommended follow-up assessment where applicable. Appropriate screening measures may include blood pressure measurement, urine assessment, serum creatinine and estimated glomerular filtration rate (eGFR), depending on the study setting and clinical protocol. Descriptive statistics will be used to summarize participants' sociodemographic characteristics, CKD knowledge, exposure to education, and screening uptake. Inferential statistical techniques, including chi-square tests, paired-sample tests, independent-sample tests, and multiple logistic regression analysis, will be used to determine the impact of CKD education on kidney disease screening uptake. Appropriate diagnostic tests will also be conducted to assess the reliability of the research instrument, model assumptions, goodness of fit, and robustness of the findings. The study is expected to find that CKD education has a significant positive impact on kidney disease screening uptake among adults in Nigeria. Adults exposed to structured CKD education are expected to demonstrate improved knowledge of kidney disease, greater awareness of risk factors, increased perception of personal susceptibility, and greater utilization of appropriate screening services. Education may also encourage adults with risk factors such as hypertension or diabetes to seek regular kidney health assessment and appropriate professional care. However, education alone may not guarantee screening uptake because adults may continue to face barriers such as screening costs, limited availability of diagnostic services, geographical distance, transportation difficulties, low awareness of available facilities, and inadequate access to healthcare professionals. Consequently, CKD education is expected to be most effective when supported by accessible, affordable, reliable, and appropriately integrated kidney disease screening services within primary and secondary healthcare settings. The study is expected to contribute to the literature on chronic kidney disease prevention, non-communicable disease control, health education, screening, early detection, health promotion, and public health in Nigeria by providing empirical evidence on the impact of CKD education on kidney disease screening uptake among adults. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, National Primary Health Care Development Agency (NPHCDA), state ministries of health, hospitals, primary healthcare facilities, nephrology services, community health workers, public health professionals, non-communicable disease programmes, development partners, and policymakers regarding strategies for improving early detection of kidney disease. The study will also provide evidence-based recommendations for strengthening community-based CKD education, integrating kidney health assessment into appropriate routine healthcare services, increasing access to affordable screening, improving referral and follow-up systems, and promoting awareness of kidney disease risk factors among adults across Nigeria.

Keywords: Chronic kidney disease education, kidney disease screening uptake, chronic kidney disease, adults, kidney health, early detection, screening practices, non-communicable diseases, health education, health promotion, public health, Nigeria.