Do Uncontrolled Hypertension, Diabetes, Dyslipidemia, and Obesity Mediate the Relationship Between Health Literacy and Chronic Kidney Disease Complications?

Matheus Gurgel do Amaral, Sijmen A. Reijneveld, Josue Almansa, Gerjan Navis and Andrea F. de Winter
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Matheus Gurgel do Amaral: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands
Sijmen A. Reijneveld: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands
Josue Almansa: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands
Gerjan Navis: Department of Nephrology, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands
Andrea F. de Winter: Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, Hanzeplein 1, 9700RB Groningen, The Netherlands

IJERPH, 2021, vol. 18, issue 10, 1-10

Abstract: Health literacy is the ability to deal with information related to one’s health. Patients with low health literacy and chronic diseases, such as chronic kidney disease (CKD), have poor disease-management skills, which could lead to complications. We used logistic regressions and structural equational modeling to assess whether low health literacy is associated with the development of cardiovascular disease and mortality in patients with CKD, and whether this association is mediated by the presence of uncontrolled hypertension, diabetes, dyslipidemia, obesity, or albuminuria. Data from 2742 adult participants with CKD from the Lifelines study were analyzed at baseline and after approximately four years. Low health literacy was associated with cardiovascular disease and mortality in the crude models, with OR and 95%CI of 1.93 (1.46 to 2.55) and 1.59 (1.08 to 2.36), respectively. After adjustment for age and sex, low health literacy was only associated with cardiovascular disease (OR 1.76 (1.31 to 2.23)). This association was mediated by uncontrolled diabetes (27.1%) and obesity (8.0%). Low health literacy is associated with the development of cardiovascular disease after adjustment for age and sex, and this association is mediated by uncontrolled diabetes and obesity.

Keywords: health literacy; chronic kidney insufficiency; cardiovascular disease; mortality; diabetes mellitus; obesity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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