MARKET RESEARCH – Project Chronic Kidney Disease

We are looking for people that have been diagnosed with Chronic Kidney Disease to take part in a telephone interview or an in-home interview.

Please answer the questions below.

Name:

Telephone number:

Home Postcode:

Age:

Job Title:

Working status i.e., Student, Full time working, part time working etc.

Who do you live with at home?

Which of the following have you been diagnosed with?

• Anaemia
• Chronic kidney disease
• Chronic pain
• Diabetes
• Heart failure
• High Cholesterol
• High blood pressure
• Kidney stones
• Osteoporosis
• Systemic lupus

How long ago were you diagnosed with chronic kidney disease?

Which stage of CKD are you currently at?

• Stage 1 (GFR OVER 90)
• Stage 2 (GFR 60 OR OVER)
• Stage 3 (GFR 30-59)
• Stage 4 (GFR 15-29)
• Stage 5 (GFR UNDER 15)
• Stage 5 dialysis
• Unsure

Have you received a kidney transplant? Yes/No?

Are you currently undergoing dialysis? Yes/No?

Which of the following types of healthcare professionals have been involved in managing your CKD?

• GP
• Nephrologist
• Endocrinologist/Diabetologist
• Haematologist
• Cardiologist
• Other – Please specify

Please list all the medications that you take currently.

Do you take any medications for low iron, anaemia or iron deficiency? Yes/No?

Please forward this on to anyone you know who may be interested.

Unfortunately, it is impossible to reply to all emails or phone messages.   We receive lots of responses to researches that are emailed out. You will be contacted by phone if your application is successful. However, we apologise if you do not hear from us, but please keep trying for future projects that are sent out.

We look forward to hearing from you.
 
Kind regards,
 
 
Daliah Salem
trend MARKET RESEARCH LTD