ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2023
Prospective associations of health literacy with clinical outcomes in adults with CKD: findings from the CRIC study.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effectiveness of mHealth Interventions for Improving eHealth Literacy Among Patients With Chronic Diseases: Meta-Analysis and Systematic Review.Journal of medical Internet research · 2026Pooled it
- Adaptation of Navigate-Kidney: A Community Health Worker Intervention for People With Kidney Disease.Kidney international reports · 2026Article
- Kidney Disease: Improving Global Outcomes Summit Recommendations on Implementation of Diabetes Management in CKD: From Primary to Data-Driven Collaborative Care.Kidney international reports · 2025Article
- Health literacy and self-care in patients with heart failure: a cross-sectional study.Frontiers in public health · 2025Observational
- Neighborhood Socioeconomic Status and Cardiovascular Events in Adults With CKD: The CRIC Study.Kidney medicine · 2024Article
- Patients' Perspectives on the Acceptability and Effectiveness of a Community Health Worker-Led Intervention to Increase Chronic Kidney Disease Knowledge and Screening among Underserved Latine Adults: The CARE 2.0 Study.Behavioral sciences (Basel, Switzerland) · 2024Article
- Community-Engaged Research (CEnR) to Address Gaps in Chronic Kidney Disease Education among Underserved Latines-The CARE Study.International journal of environmental research and public health · 2023Article
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Authors and funding
14 authors.
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Abstract
backgroundLimited health literacy is associated with significant morbidity and mortality in the general population but the relation of health literacy with long-term clinical outcomes among adults with chronic kidney disease (CKD) is less clear.
methodsProspective data from the Chronic Renal Insufficiency Cohort (CRIC) Study (n = 3715) were used. Health literacy was assessed with the Short Test of Functional Health Literacy in Adults (dichotomized as limited/adequate). Cox proportional hazards models were used to separately examine the relations of health literacy with CKD progression, cardiovascular event (any of the following: myocardial infarction, congestive heart failure, stroke or peripheral artery disease), and all-cause, cardiovascular and non-cardiovascular mortality. Poisson regression was used to assess the health literacy-hospitalization association. Models were sequentially adjusted: Model 1 adjusted for potential confounders (sociodemographic factors), while Model 2 additionally adjusted for potential mediators (clinical and lifestyle factors) of the associations of interest.
resultsIn confounder-adjusted models, participants with limited (vs adequate) health literacy [555 (15%)] had an increased risk of CKD progression [hazard ratio (HR) 1.34; 95% confidence interval (CI) 1.06-1.71], cardiovascular event (HR 1.67; 95% CI 1.39-2.00), hospitalization (rate ratio 1.33; 95% CI 1.26-1.40), and all-cause (HR 1.54; 95% CI 1.27-1.86), cardiovascular (HR 2.39; 95% CI 1.69-3.38) and non-cardiovascular (HR 1.27; 95% CI 1.01-1.60) mortality. Additional adjustments for potential mediators (Model 2) showed similar results except that the relations of health literacy with CKD progression and non-cardiovascular mortality were no longer statistically significant.
conclusionsIn the CRIC Study, adults with limited (vs adequate) health literacy had a higher risk for CKD progression, cardiovascular event, hospitalization and mortality-regardless of adjustment for potential confounders.
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