1. Introduction

Kidney disease (KD) is a significant global public and clinical health problem [1, 2]. Acute kidney injury (AKI) and chronic KD (CKD) are associated with poor quality of life, high healthcare expenses, and serious adverse health outcomes [1, 3]. AKI is mostly caused by diarrheal disease with dehydration, infectious diseases (malaria, dengue, yellow fever, leptospirosis, tetanus, and human immunodeficiency virus), animal venom, septic abortion, renal ischemia, sepsis, and sometimes nephrotoxic drug [4]. Studies have stated that the prevalence of CKD is higher in developing countries than in the developed world and is commonly caused by chronic glomerulonephritis and systemic hypertension [5].

Over 10% of individuals worldwide suffer from CKD, and this number rises to 50% in high-risk subpopulations such as those with diabetes mellitus and hypertension [6]. Poor control of major CKD risk factors, particularly diabetes mellitus and hypertension, is also partly responsible for the high incidence of CKD. These factors include delayed health-seeking behavior, lack of access to excellent primary health services, and use of traditional herbal medicine to treat these conditions [6–8]. Additionally, an acute decrease in glomerular filtration rate is a risk factor for adverse clinical outcomes as well as the development and progression of CKD [9].

Tahir et al. observed knowledge gaps in KD among medical trainees and practitioners [10]. Improved training on kidney physiology, pathology, prevention, risk assessment, diagnosis, and interdisciplinary management approaches is vital during the training of future allied health professionals. However, there has been no study in Ghana performed to assess the knowledge levels of KDs and their risk factors among allied health sciences undergraduates who would in no time pass out to practice in the field of healthcare. Thus, this study assessed the knowledge of KDs and their associated risk factors among allied health sciences undergraduates, expecting that the findings will be useful in determining constructive approaches to improve their health education on KDs.

2. Methodology

3. Results

3.2. Level of Knowledge of Kidney Diseases Among Participants

The majority of study participants had high knowledge (61.9% (237/383)). Nearly 65% of females and 59% of males had high knowledge (Figure 1).

The overall average knowledge score of respondents was 20.86 ± 3.88 out of a maximum score of 27 (77.26%) (Table 2). High knowledge level was observed for types and stages, diagnosis, and associated risk factors for KD (76.8% (3.84/5), 75.3% (5.27/7), and 81.6% (8.98/11), respectively) while moderate knowledge level was observed for signs and symptoms (69.3% (2.77/4)) (Table 2).

Table 2. Knowledge on types and stages, signs and symptoms, diagnosis, and risk factors of kidney disease among participants.

Questions	Answers	Responses (N)	Frequency (%)	Mean knowledge score ± SD (maximum score)
Overall knowledge of kidney disease				20.86 ± 3.88 (27.00)
Types and stages of kidney diseases				3.84 ± 1.22 (5.00)
Kidney diseases are mainly classified as	Severe, moderate, or mild	36	9.4
	Acute or chronic	335	87.5
	Symptomatic or asymptomatic	12	3.1
Reversible traumatic kidney injuries can best be described as what type of kidney disease	Mild	86	22.5
	Symptomatic	27	7.0
	Chronic	3	0.8
	Acute	267	69.7
Irreversible traumatic kidney injuries can best be described as what type of kidney disease	Severe	75	19.6
	Asymptomatic	5	1.3
	Chronic	301	78.6
	Acute	2	0.5
Mild kidney damage where the kidney works as normal is characterized by	Stage 1 kidney disease	288	75.2
	Stage 2 kidney disease	62	16.2
	Stage 3 kidney disease	12	3.1
	Stage 4 kidney disease	7	1.8
	Stage 5 kidney disease	14	3.7
Stage 5 kidney disease is usually associated with itching and hyperuremia	Yes	279	72.8
	No	104	27.2
Signs and symptoms of kidney diseases				2.77 ± 0.83 (4.00)
Abdominal pains and urination difficulty can be considered as early signs of kidney disease	Yes	331	86.4
	No	52	13.6
Fatigue is a major symptom of kidney diseases	Yes	266	69.5
	No	117	30.5
Advanced symptoms of kidney diseases include swelling of extremities and shortness of breath	Yes	330	86.2
	No	53	13.8
Consistently high blood pressure is a sign of a	Symptomatic kidney disease	42	10.9
	Acute kidney disease	132	34.5
	Chronic kidney disease	209	54.6
Diagnosis of kidney diseases				5.27 ± 1.47 (7.00)
eGFR is the best diagnosis marker for kidney disease patients	Yes	314	82.0
	No	69	18.0
Albumin to creatinine ratio (ACR) may be used to detect the kidney diseases in patients.	Yes	333	86.9
	No	50	13.1
The following parameters will precisely help in diagnosing kidney disease of any type in patients
Creatinine concentration	Yes	265	69.2
	No	118	30.8
Hemoglobin concentration	Yes	124	32.4
	No	259	67.6
Urine albumin concentration	Yes	215	56.1
	No	168	43.9
Blood urea and nitrogen concentration	Yes	279	72.8
	No	104	27.2
Renal function test may serve as a supporting investigation for diagnosing kidney diseases in patients	Yes	354	92.4
	No	29	7.6
Risk factors of kidney diseases				8.98 ± 1.88 (11.00)
Much salt consumption causes kidney problem	Yes	321	83.8
	No	62	16.2
Drinking too much water can result in a kidney disease	Yes	87	22.7
	No	269	77.3
Drinking too little water can result in a kidney disease	Yes	317	82.8
	No	66	17.2
Smoking and alcoholism can result in a kidney disease	Yes	357	93.2
	No	26	6.8
Poorly managed hypertension and diabetes mellitus can result in a kidney disease	Yes	360	94.0
	No	23	6.0
Patients with HIV/AIDS are at risk of having a kidney impairment	Yes	306	79.9
	No	77	20.1
Patients infected with malaria and/or urinary tract infections are reasonably exposed to kidney diseases	Yes	299	78.1
	No	84	21.9
Can frequent usage of herbal medications cause kidney diseases?	Yes	310	80.9
	No	73	19.1
Persistent exposure to heat and agrochemicals can lead to a kidney disease	Yes	289	75.5
	No	94	24.5
Sickle cell disease patients are prone to kidney diseases due to dehydration?	Yes	275	71.8
	No	108	28.2
Frequent NSAID users are prone to kidney diseases	Yes	311	81.2
	No	72	18.8

• Note: Bold values are the correct answer in each section, similar to how the responses and frequency have been bolded.

While 87.5% (335/383) of participants were able to identify correctly that KDs are mainly classified as acute and chronic, only 69.7% (267/383) and 78.6% (301/383) were able to identify that reversible and irreversible KD/damage may be classified as AKI and CKD, respectively (Table 2). The majority of participants were able to identify abdominal pains and urination as early signs of KD (86.4% (331/383)) and swelling of extremities and shortness of breath as advanced symptoms (86.2% (330/383)) (Table 2).

Majority of participants were also able to point out eGFR as a diagnostic marker for KD (82.0%), albumin to creatinine ratio usage to detect KD (86.9%), and renal function test as a supporting investigation for KDs (92.4%). However, 32.4% and 43.9% of participants failed to identify hemoglobin concentration as a nonparameter for precise diagnosis of KD and urine albumin concentration as a parameter that may help in KD diagnosis, respectively (Table 2).

The commonest risk factors identified by about 80% of participants were high salt consumption, insufficient water intake, HIV/AIDS, frequent herbal medication usage, and frequent nonsteroidal anti-inflammatory drug (NSAID) use (Table 2).

4. Discussion

KDs are on the rise in developing countries and are linked to high rates of morbidity and death. In this study, we assessed the level of awareness and understanding of regular allied health sciences undergraduates regarding KDs and their risk factors.

In our study, the overall average knowledge score of KDs was found to be 20.86 ± 3.88 out of 27 (77.26%). This was higher than that observed in similar studies conducted in Ethiopia by Wolide et al. [14] and Northern Tanzania by Stanifer et al. [14, 16]. They found an overall knowledge score of 66.2% (8.6/13) and 32.8% (3.28/10), respectively [14, 16]. This variation could be due to the questionnaire used, study population, and sample size employed in various studies. The majority of participants (61.9%) in this study had a high level of knowledge about KDs, which might be due to the formal post-secondary education of study participants in the field of health. This affirms the findings of similar studies by Stanifer et al. [16] and Gheewala et al. [12, 16]. They found that those with post-secondary education knew more about KDs than people without or only with primary school education.

We also found a high knowledge level on the types and stages, diagnosis, and risk factors of KDs. In dissonance with our findings, Wolide et al. in 2019 observed that over half of their health student participants were able to identify symptoms and risk factors of KD with gaps in identifying laboratory diagnosis [14]. Further, we found a moderate knowledge level on the signs and symptoms of KDs, which might be due to the limited clinical exposure of the undergraduates. This finding further highlights some gaps in knowledge on the signs and symptoms as well as diagnosis of KDs among undergraduates reading health-related programs.

Ninety-four percent of participants were able to identify poorly managed diabetes mellitus and hypertension as risk factors for kidney diseases. However, a similar study by Roomizadeh et al. found that only 12.7% and 14.4% of study participants were able to identify poorly managed diabetes mellitus and hypertension as risk factors for CKD, respectively, in Iran’s general population. Kazley et al. also highlighted a deficiency in knowledge of KD risk factors among CKD patients in South Carolina, USA [13, 17]. Gheewala et al. [12] also found that 38.3% and 60.6% of participants correctly identified hypertension and diabetes mellitus as risk factors for CKD, respectively [12]. This indicates that the knowledge level of KDs in the general public is relatively lower compared to allied health students. This suggests that students enrolled in health-related programs should have a thorough understanding of all aspects of KDs, as this will enable them to better explain the condition to both their future patients and the general public, thereby increasing the knowledge of KD among the general public.

Among participants with active health insurance, a family history of chronic disease, and a history of alcohol consumption, high knowledge of KD was observed. Students reporting alcohol use had almost six times higher odds of high KD awareness compared to those who did not report alcohol intake (OR = 5.96, 95% CI = 2.01–22.35, p = 0.003). It is more likely that those with increased risk factors for KDs are more aware and concerned about kidney health issues. This could be due to the general idea that alcoholism in the long run causes KD as many participants in a similar study by Whitman et al. [18] identified alcohol misuse as the commonest cause of KD [18]. While alcohol misuse is a risk factor for KD, those reporting alcohol consumption may have gained knowledge through health warnings. Addiction could also impact drinking behaviors independent of understanding risks.

High knowledge of KDs among participants with a family history of chronic disease was similarly observed in Alobaidi et al.’s study in 2021 [19] and this could be attributed to these participants’ exposure to health education, awareness campaigns, and related health conditions, which fostered a higher knowledge environment about KDs during relatives’ health care. The reason for high knowledge among individuals with health insurance remains unclear, but it could possibly be due to the fact that having health insurance might facilitate access to medical care, resources, and knowledge about specific medical conditions.

Our study also revealed that participants reading health information management (20.8%) had the least number of respondents having high knowledge about KDs among the various disciplines of allied health. The curriculum for health information management program prioritizes teaching skills for processing, keeping, and managing health data. Aspects of health like disease diagnosis, pathophysiological mechanisms, epidemiological patterns, and other fundamental medical topics may receive less emphasis. This could account for this observation.

In contrast to our study which found being in the second or fourth year, having alcohol intake status, and being underweight to be significantly associated with high knowledge of KDs in the multivariate analysis, Gheewala et al. [12] observed having a higher level of education, family history of kidney failure, a personal history of diabetes mellitus, and currently or previously living in a relationship to have significantly higher CKD knowledge scores [12]. The variations in results could be attributed to the study population and questionnaires employed in both studies. Additionally, underweight students could have pre-existing health issues prompting extra research into conditions.

The study may be limited by subject selection bias. We used random sampling methods where only voluntary subjects participated. Also, we were not able to compare our study with other studies in the region due to a lack of information in the area.

5. Conclusion

The findings of this study showed that allied health science undergraduates had adequate knowledge regarding KD and its risk factors. However, knowledge on the signs and symptoms of KDs was relatively low among participants. This shows the need to improve the current training of allied health undergraduates by integrating more content on KDs into their curriculum and providing them with more clinical exposure involving patients with KDs.

Conflicts of Interest

The authors declare no conflicts of interest.

Author Contributions

R.K.D.E., V.O.O., T.J.Y., M.A.E., and G.N.O. conceived and designed this study. V.O.O., T.J.Y., M.A.E., and T.A. were responsible for data collection. G.N.O. and M.A.E. were responsible for data analysis and visualization. R.K.D.E., T.A., and G.N.O. drafted the manuscript. All authors revised the manuscript critically for important intellectual content. All authors read and agreed with the final manuscript.

Funding

The authors received no specific funding for this work.