Knowledge of physicians on chronic kidney disease and their attitudes towards referral, in two cities of Cameroon: a cross-sectional study.

backgroundChronic kidney disease (CKD) is frequently unrecognized by non-nephrology physicians. There is an ongoing governmental program to create hemodialysis centers in the ten regions of Cameroon, where a previous study reported high levels of late referral to nephrologists. We aimed to assess the knowledge of physicians on CKD and their attitudes regarding referral.

methodsA questionnaire based on the Kidney Disease Outcome Quality Initiative Guidelines of 2002 was self-administered to general practitioners and non-nephrology specialists working in two Cameroon cities that have hemodialysis centers (Douala and Bamenda).

resultsOf the 174 general practitioners and non-nephrology specialists approached, 114 (65.5%) returned answered questionnaires. Only 58.8% of doctors identified the correct definition of CKD. Most physicians were aware of the major risk factors of CKD (hypertension, 97.4% and diabetes mellitus, 95.6%). Most physicians were also aware of complications such as anemia (93.0%), hypertension (90.4%), uremia (85.1%) and hyperkalemia (85.1%). Only 44% knew that CKD had five stages, with general practitioners 3.4 times more likely to know than specialists (p = 0.004). Even though 61.4% of the physicians knew that the estimated glomerular filtration rate was the appropriate clinical means to diagnose CKD, 12.7% would use serum creatinine alone for diagnosis. Also, up to 21.9% of physicians would refer at late stage.

conclusionGeneral practitioners and non-nephrology specialists lack general knowledge on CKD, especially on the definition and staging; they also have inadequate attitudes with regards to diagnosis and referral to the nephrologists. Educational efforts are warranted to improve on physicians' knowledge and skills on CKD in Cameroon.