`Think Kidneys`? A study of knowledge levels in the general population

Selby NM, Taylor A, Cullen R, Mills P, Russell J, Thomas K and Fluck RJ
(on behalf of NHS England ‘Think Kidneys’ AKI Programme)
Little is known about public knowledge and awareness of kidney function in health and illness. This
has relevance to the prevention and early recognition of renal disease, as well as potential
effectiveness of self-care management approaches.
Ipsos MORI, a private UK research company, was commissioned to survey a nationally representative
sample of adults (age ≥15yrs old) from across Great Britain. Face to face interviews using computer
assisted personal interviewing techniques were conducted in 2005 people over a 10 day period
between 4th and 14th July 2014 as part of Capibus, Ipsos MORI’s face to face omnibus survey.
Standardised questions (multi-response multiple choice questions) regarding kidney function and
acute kidney injury (AKI) were asked as part of a broader questionnaire that included a variety of
unrelated subjects (education, healthcare, crime, the monarchy, race, business and politics). Data
were weighted by gender within age, government office region, social grade and working status as
well as household tenure and ethnicity to match known population proportions for adults 15+ in Great
Within the sample there was a nationally representative spread of respondents across age categories,
socioeconomic grouping and educational background. In general, knowledge levels of kidney function
were low. 49% of respondents did not know that the kidneys make urine; 40% did not know that the
kidneys were responsible for eliminating toxins from the body. 65% did not know that the kidneys
had a role in regulation of volume status and only 12% of respondents considered that the kidneys had
a role in drug metabolism/elimination. 8% thought that the kidneys had a role in ‘pumping blood and
fluid around the body’.
There was also a high level of misunderstanding about causes of kidney disease (AKI). 68% of
participants considered that alcohol was nephrotoxic, and although there was a greater appreciation
that dehydration could adversely affect kidney function this was still only recognised by 58%. Only
8% of respondents claimed to have heard the term ‘Acute Kidney Injury’ and were able to indicate its
correct meaning; conversely 34% thought that AKI referred to physical trauma. 78% of participants
did not know that medications have the potential to cause a reduction in kidney function. There were
variations in some responses between different UK geographical areas and across socioeconomic
Public knowledge levels about the normal functioning of the kidney are low and there is a high level
of misconception around common aetiological factors of AKI. The lack of awareness that medications
may affect renal function is a particular concern. In addition to missed opportunities in individual
patient pathways of care, low public perception of kidney disease is likely to contribute to a failure of
resource allocation both in terms of provision of clinical nephrology services and in research funding.
A public-facing campaign to raise awareness of kidney disease should become a strategic priority.
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