POS-016 IDENTIFYING KIDNEY DYSFUNCTION IN THE COMMUNITY SETTING: THE ISN KIDNEY CARE NETWORK PROJECT

Community-acquired acute kidney injury (AKI) is common, but often unrecognized in resource-constrained settings. Limited education about disease and unavailability of diagnostic tests contribute to this lack recognition. In study, we evaluated the feasibility an program, coupled with use a point-of-care (POC) serum creatinine (sCr), identify guide management patients dysfunction presenting community health centers (CHC) emergency departments (ED) low-resource This study was undertaken as part International Society Nephrology (ISN) Kidney Care Network project, successor 0by25 Pilot Feasibility Project. Patients at participating CHCs or EDs Nepal, Bolivia, South Africa Brazil symptoms signs associated high/moderate risk underwent sCr POC testing. Staff these care were trained evaluation AKI. Patient demographics etiology on presentation recorded. Local practitioners determined if be treated locally transferred referral for management. Treatments AKI recorded well patient outcomes discharge over follow-up up 3 months after initial presentation. Complete recovery defined value returning back baseline partial improvement from peak not baseline. 4319 screened, 4242 (98.2%) enrolled (2028 858 1173 183 Brazil). The screening form completed 4236 patients, assessments 1 – 4099, 3788 2432 cases respectively. Type facility varied by country 99.2% recruited Tertiary Hospital 69.6% 80.0% District Hospitals Bolivia respectively, 98.6% Health Centers Africa. Mean (SD) age 55 (19) years, 2378 (58%) female. Median (IQR) 1.4 (1.0-1.9) mg/dl. It recommended that 165 (3.9%) higher level care, 125 (75.8%) transferred. percentage site, highest (7.1%) (5.1%). Dialysis performed rarely, only 12 entire cohort. completion episode are shown Table.2316 (14.6%) followed-up median time 84 (71-91) days. At point 221 (9.5%) had died.View Large Image Figure ViewerDownload Hi-res image Download (PPT) Education local healthcare workers alongside multiple settings feasible identified significant number who would otherwise have gone unrecognized. Most able site Whilst mortality during low, 9.5%. Factors will investigated advocacy activities make approach managing sustainable.