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.
"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
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.
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,
0by25 is endorsed by many regional and national nephrology societies worldwide
and welcomes support from partners across the global healthcare community.