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Article Diabetes and Chronic Kidney Disease in Turkey (DIAKIT): A Cross-Sectional Cohort Study(BMC, 2025) Arici, Mustafa; Ates, Kenan; Yildiz, Alaattin; Odabas, Ali R.; Tokgoz, Bulent; Sezer, Siren; Altun, BulentBackground Chronic kidney disease (CKD) is a global public health problem with increasing disease burden affecting nearly 10% of adult population worldwide. We aimed to detect the prevalence of CKD, patients' distribution among CKD stages, and factors associated with having CKD in diabetic patients in Turkey. Methods This cross-sectional study, conducted in 2022, included 1591 patients with diabetes (mean age, 63 +/- 10 years; female: 65.5%) from the Cappadocia Cohort study. CKD was diagnosed by an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m(2) or urinary albumin-to-creatinine ratio (UACR) >= 30 mg/g, which was measured in spot urine samples collected in the morning for three consecutive days. Results In this cohort of adult diabetic patients, the prevalence of CKD was 25.1%. More than half of the diabetic patients with CKD (53.8%) had albuminuria without a decrease in eGFR, 28.1% had decreased eGFR without albuminuria, and 18.2% had both albuminuria and decreased eGFR. While the percentage of CKD patients who are female vs. male was 60% vs. 40%, CKD prevalence was higher in males (29.2%) than in females (22.9%) (P = 0.007). Among patients with CKD, only 9.4% were aware that they had CKD. Age, male sex, HbA1c, triglyceride, uric acid, C-reactive protein, and hypertension Grade 1, 2 and 3 were associated with the presence of CKD, with uric acid showing the strongest association. Conclusions More than half of our patients with CKD would not have been diagnosed if urinary albumin excretion was not measured. Early detection of CKD by regular screening of diabetic patients using both UACR and eGFR measurements is essential for early diagnosis and prompt treatment to slow down disease progression.Article Citation - Scopus: 1Development of a Questionnaire To Assess Phosphate Knowledge in Children With Chronic Kidney Disease and Their Caregivers(John Wiley and Sons Inc, 2025) McAlister, L.; Shaw, V.; Pugh, P.; Joyce, T.; Snauwaert, E.; Bathgate, F.; Lambert, K.Introduction: Hyperphosphataemia is a common complication of paediatric chronic kidney disease (CKD), despite the use of phosphate binders and the numerous strategies employed to reduce dietary phosphate (P) intake. This article describes the development of two self-administered semi-structured Phosphate Understanding and Knowledge Assessment (PUKA) questionnaires. The purpose of these is to assess challenges with adherence and measure declarative nutrition and procedural knowledge of phosphate in children and young people (CYP) with CKD and their caregivers. The aim is to create questionnaires that will be used for future studies investigating the relationship between knowledge and blood P-levels. Methods: Questions were generated from a literature review, clinical experience and feedback from a survey sent to UK paediatric kidney dietitians. The content, format and style of the questions were adapted and validated via expert consensus (including a psychologist, play therapist, paediatric kidney dietitians and nephrologists from the international Paediatric Renal Nutrition Taskforce, and our Young Persons’ Advisory Group), two caregivers and two CYP. A draft questionnaire was piloted with five caregivers and CYP with CKD to ensure face and content validity. To allow utilisation in a planned multi-centre trial, it was translated into five languages (Dutch, French, German, Italian and Turkish). The final English version questionnaires were used in a sample of CYP with CKD stages 4–5 and on dialysis (CKD4-5D), and caregivers, from three UK paediatric kidney centres. Results: From an initial pool of 80 questions, 37 were included in the final PUKA questionnaire. Thirteen were knowledge-based, and a knowledge score was developed. An adult and a child-friendly format were designed. Pilot testing confirmed face validity to ensure the questions were understandable. Forty-four CYP with CKD4-5D and 33 caregivers completed the final English PUKA questionnaires, with over 80% rating it easy to complete. The median time required to complete it was 11:06 min (IQR: 7:22–16:31). Conclusions: The PUKA questionnaires are a valid and reliable tool for measuring P-related knowledge and experiences of managing phosphate in CYP with CKD and their caregivers. © 2025 The British Dietetic Association Ltd.
