Sources of information on kidney health

Verbal explanations from doctors and nurses were the main source of information about kidney impairment among the people we spoke to. But it was common for people to say they had been given only a brief explanation of their kidney impairment, alongside being told it was typical for someone of their age and nothing to worry about (see ‘The words doctors used to explain kidney impairment‘). Some didn’t realise that their kidney performance was impaired or that it was being monitored. This reluctance of some doctors to give information about kidney impairment is probably because they wish to avoid alarming patients about a condition that is unlikely to cause them any problems (see ‘Why is kidney health important?‘ and ‘How and why is kidney function monitored?‘).

All Sarah had been told by her GP was that most older people have mild kidney impairment and not to worry about it.

Age at interview 77

Gender Female

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Among those who had been told details of their kidney performance – either the stage of chronic kidney disease (CKD) (a number from one to five where five is worse kidney performance) or the estimated glomerular filtration rate (eGFR) (a number ranging from 1 to 90 or more where a higher figure means better kidney performance) – some said they didn’t really understand what it meant. A few had been given a graph showing changes in their eGFR over time, which they found more understandable than being told a single figure at one point in time. See ‘How and why is kidney function monitored?‘ for a more detailed explanation of CKD stages and the eGFR.

A GP told Kath her kidney performance was around 40 and it would have to drop to 30 before they would test her more regularly, and to 10 before dialysis became necessary, but Kath didn’t understand the numbers.

Age at interview 72

Gender Female

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Jackie has a new GP who has explained much more about her kidney impairment than any of her previous doctors; this has motivated her to do everything she can to keep healthy.

Age at interview 59

Gender Female

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When inviting Flo to take part in this interview, her GP showed her a graph of her kidney performance that she had not seen before. It was reassuring to see how it had stabilised.

Age at interview 70

Gender Female

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Although there are leaflets about early stage chronic kidney disease written for patients (see resources section) it was rare for the people we spoke to have been given one, whereas they were used to being given leaflets about other medical conditions or picking them up in their doctor’s surgery. A few recalled being given a leaflet when they were first referred to a kidney specialist. Bill had been sent one by his GP with the invitation to take part in this interview.

Tina was given leaflets at the hospital kidney clinic but didn’t understand all the language used; she prefers face-to-face explanations.

Age at interview 54

Gender Female

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People recalled various specific bits of information about kidney disease they had learned from a health professional. Laura’s GP had told her seventeen years ago that there was a one-in-three chance of her kidneys failing within ten years and had put her in touch with one of the kidney charities. Lesley and Simon had been told by a GP that their kidney impairment had been caused by long-term use of a prescription drug (see ‘Awareness of kidney disease and beliefs about possible causes‘). Jackie has had kidney disease since childhood and was warned by her GP that it could lead to a problem with her bones. Tony’s kidney specialist drew a diagram to show how a vessel connected to one of his kidneys had narrowed.

Flo was worried after learning from her GP that her kidneys were leaking protein into her urine. But she felt reassured after a nurse that she saw regularly explained what this meant.

Age at interview 70

Gender Female

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Lifestyle had often been mentioned by a doctor or nurse, and several people, particularly those who had diabetes, said they had been given information about recommended dietary changes. People may be referred to a dietitian for more detailed advice but Lesley found the dietitian’s advice contradicted what she had found on the internet for people with kidney disease. A pharmacist had given Xanthe dietary information tailored for people with kidney problems.

Not everyone wanted much information about their kidney impairment and preferred to trust the professional’s judgement of what they needed to know. A few said they would ask for more if they felt a need. Robert said he didn’t want to take up the doctor’s time. Jill, aged 77, said that she would probably want more information if she was younger. Harry and Pat felt that too much information could be damaging.

Harry believes that looking up health information can sometimes result in unnecessary anxiety; he prefers to talk to a doctor about health problems.

Age at interview 78

Gender Male

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Information from books, the internet or the kidney charities could all be useful. Sarah learned from one of the charities that people with kidney problems should avoid using non-steroidal anti-inflammatory medicines, such as ibuprofen, for long term pain relief. Xanthe was sent a booklet of exercises from one of the kidney charities.

Xanthe had phoned the National Kidney Federation several times with questions about her kidney health and received their quarterly magazine.

Age at interview 72

Gender Female

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Laura had obtained information about kidney disease from books and a magazine produced by one of the kidney charities.

Age at interview 60

Gender Female

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Nowadays, most people use the internet to look for information on a wide range of topics including health issues. Some people we spoke to had used the internet to look up information about kidney impairment, while others had used it for other medical conditions but not so far for their kidney health. Peter had looked up information about the medicines he was taking and how other people experienced the side effects; Martin had looked for information about atrial fibrillation. Joanne had searched for information on kidney disease and had found nothing that caused her to worry about her condition. Mike learned that high blood pressure could be linked with kidney impairment and that it was possible to live normally with the equivalent of only one kidney. Lesley had looked for symptoms of kidney disease and dietary guidance; she also found a private kidney specialist. Justine had looked up information about what having a kidney biopsy involved before having one herself.

The quality of online information was a concern, and some people recommended only visiting reputable websites, such as NHS Choices or Patient.co.uk, in order to obtain reliable information. People could sometimes regret looking online if they found information they had not wanted or which disturbed them.

John only uses reputable websites to look up health information. He was reassured by the information he found about kidney impairment.

Age at interview 75

Gender Male

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When James had blood in his urine he was alarmed to learn on the internet that it could indicate a serious condition; after investigations his problem was found to be associated with prostate rather than kidney disease.

Age at interview 71

Gender Male

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Many people we spoke to who had not sought out information for themselves had questions about their kidney condition that they wanted answering (see ‘People’s ongoing information and support needs‘).

For factual information sources about early kidney impairment see ‘Resources‘ section.