The International Society of Nephrology (ISN), Cape Town, South Africa, presented the findings of a new global study on Acute Kidney Injury (AKI). In its annual meet that is being held until 17 March, the study 'Global Snapshot' focused on strategies for elimination of preventable deaths due to AKI by 2025.
According to the study, more than 65% of AKI cases were reported to be community acquired, rather than developing in the hospital setting. This is a significant new finding, which points to an opportunity and need for early recognition and detection in these out-of-hospital settings.
The most common causes of AKI reported across all countries were: hypotension (low-blood pressure) and shock, infections, dehydration, cardiac events and nephrotoxic drugs. It was also reported that over 65% of the AKI cases had one or more of the recognized risk factors such as diabetes, heart disease and anemia, and patients with these risk factors experienced a higher mortality and lower rate of recovery of kidney function.
Advertisement"This study provides us with clear evidence of the need to identify and target high risk groups to improve the prevention and early detection of AKI," said Dr. Ravindra Mehta, 0by25 Project Leader and Global Snapshot Coordinator. "This essential new information can now be used to design targeted education and training to enable the rapid recognition of AKI."
The Global Snapshot also found that an average of 25% of AKI patients seen by the participating centers required dialysis, but did not receive treatment. This was predominantly due to the late presentation and disease severity of patients, adding further weight to the argument for early detection and management of AKI. In some cases, a lack of healthcare and financial resources were also reported as barriers to treatment.
Finally, the data findings suggest that over 30% of AKI patients were not managed by a nephrologist (kidney expert), a finding that was even more prevalent in low-income countries. "The ISN recognizes that AKI is a multi-disciplinary problem and this data just confirms that education and training collaboration with other healthcare disciplines to raise awareness and educate and train non-nephrologists will be essential to reducing the global burden of AKI," adds Dr. Mehta.
AKI is an extremely serious illness with a high mortality risk and can have many underlying causes. Some of these include hypertension, diabetes and numerous infectious diseases and agents such as malaria, Shigella Dysenteriae type 1, Hantavirus, dengue and leptospirosis, as well as poisoning, septic abortion, community-acquired diarrhea, and other syndromes such as hemolytic-uremic syndrome, pregnancy-related syndromes and acute glomerulonephritis.
The study was carried out in 2014 from September to December with over 320 participating centers in 72 countries globally. Data was provided for over 4,000 pediatric and adult patients, with significant new information coming from Africa, Asia, and Latin America.
"This is the first time that ISN has carried out a web-based, prospective data collection exercise, simultaneously, in hundreds of centers around the world," said Dr. Giuseppe Remuzzi, ISN President. "The study has helped us address the information gap on AKI and moved us a step closer to our goal of zero preventable deaths. "
AKI is a worldwide problem, killing patients who have no means to reach appropriate therapy in developing countries, and who could be saved with as little as $150. Such a far-reaching, cross-sectional, global cohort study was designed to better understand the growing burden of AKI and how it is identified, managed and treated in different settings worldwide.
About The International Society of Nephrology and Oby25 Initiative
The International Society of Nephrology is a global not-for-profit society dedicated to improving kidney care and reducing the incidence and impact of kidney disease worldwide. Through its global network and programs, ISN brings together the developing and developed world in a collaborative effort in fighting and treating kidney disease on a global scale.
The 0by25 Initiative aims to eliminate preventable deaths from AKI by 2025. A global human rights initiative, 0by25 places a strong emphasis on low and middle-income countries in Africa, Asia, and Latin America with disadvantaged populations and poor access to care.
The International Society of Nephrology (ISN) provides funding through unrestricted grants to the 0by25 initiative and gave logistic support for the Global Snapshot study. Further support has been provided through unrestricted grants from 0by25 founding partner Astute Medical (San Diego, CA, USA) and partners Danone Nutricia Research (Palaiseau, France) and Bellco (Mirandola, Italy).
0by25 is endorsed by many regional and national nephrology societies worldwide and welcomes support from partners across the global healthcare community.