Recognition and management of community-acquired acute kidney injury in low-resource settings in the ISN 0by25 trial: A multi-country feasibility study

by Etienne Macedo, Ulla Hemmila, Sanjib Kumar Sharma, Rolando Claure-Del Granado, Henry Mzinganjira, Emmanuel A. Burdmann, Jorge Cerd á, John Feehally, Fredric Finkelstein, Guillermo García-García, Vivekanand Jha, Norbert H. Lameire, Euyhyun Lee, Nathan W. Levin, Andrew Lewington, Raúl Lombardi, Michael V. Rocco, Eliah Aronoff-Spencer, Marcello Tonelli, Karen Yeates, Giuseppe Remuzzi, Ravindra L. Mehta, for the ISN 0by25 Trial Study Group BackgroundAcute kidney injury (AKI) is increasingly encountered in community settings and contributes to morbidity, mortality, and increased resource utilization worldwide. In low-resource settings, lack of awareness of and limited access to diagnostic and therapeutic interventions likely influence patient management. We evaluated the feasibility of the use of point-of-care (POC) serum creatinine and urine dipstick testing with an education and training program to optimize the identification and management of AKI in the community in 3 low-resource countries. Methods and findingsPatients presenting to healthcare centers (HCCs) from 1 October 2016 to 29 September 2017 in the cities Cochabamba, Bolivia; Dharan, Nepal; and Blantyre, Malawi, were assessed utilizing a symptom-based risk score to identify patients at moderate to high AKI risk. POC testing for serum creatinine and urine dipstick at enrollment were utilized to classify these patients as having chronic kidney disease (CKD), acute kidney disease (AKD), or no kidney disease (NKD). P...
Source: PLoS Medicine - Category: Internal Medicine Authors: Source Type: research