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Tuesday, 26 April 2016 14:46

Clinical Research: Risk assessment tool kit for community acquired Acute Kidney Injury

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image mcedoName: Etienne Macedo 

Hospital / Affiliation: UCSD

Home Country: Brazil 

Host Country: USA 

Year: 2015

Status of the program: completed

 

 

Title of the project :

Risk assessment tool kit for community acquired acute kidney injury   

Topic: 

Acute kidney injury 

Short Description of the Project or Abstract:

Over the last few years, information and guidelines on diagnosis and management of Acute Kidney Injury (AKI) have emerged and have been largely implemented in hospital settings in the developed world. There has been limited progress in incorporating this knowledge in the developing world, particularly in recognizing patients at high risk for developing AKI. Since AKI is not associated with any specific symptoms and the diagnosis is largely based on assessment of lab parameters, AKI is often not recognized, particularly in a community setting. In addition to patient risk factors, environmental and infrastructure particularities, such as inadequate sanitation, limited clean water availability, inadequate control of parasites, infection-carrying vectors and poor transportation increases the risk of AKI. We believe that early identification of patients at increased risk for AKI is the first step for implementing preventive strategies. Then, clear risk assessment protocols can potentially improve outcomes in AKI. In this context, the development of risk scores to estimate the probability of AKI development is still an underutilized tool. Several risk scores for AKI have already been proposed. However, most of the available scores are specific for a risk setting, e.g. ICU, post-operative setting, and were developed based on data from hospitalized patients in developed countries.

There is a need for a pragmatic, easy to use tool to enable physicians to identify and follow high-risk patients based on clinical parameters particularly in low resource settings. The development of a simple clinical based tool to predict AKI in community patients would potentially help health care providers to determine level of care, interventions and need for follow up. This approach would be possible for the majority of low and for high-income countries. Our project utilized clinical information from health care centers in Africa, Asia and South America to develop multiple logistic regression model to predict moderate and severe AKI. Our risk model incorporated data on sign and symptoms at health care admission, etiological factors, inherent risk factors and exposures contributing to the development of AKI. We will validate the tool in community health care centers and evaluate the performance to help health care providers to determine level of care, interventions and need for follow up.

 

Learning or Research objectives:

  • Develop a simple clinical tool to predict the likelihood of developing AKI in the Low Middle Income Country (LMIC) world
  • Assess the predictive performance of the tool to assess the course of kidney function in patients at risk for AKI in LMIC
  • Assess the feasibility of implementing a risk assessment tool for AKI in different regions in the world.
  • Assess the feasibility of using the tool to determine the need for further point of care test and triaging for additional care.

Additional Info

  • Year: 2015
  • Status: Completed
  • Partners: ISN only
  • Region: Latin America and the Caribbean, North America and the Caribbean
  • Country: Brazil
  • Topics: AKI
Read 7071 times Last modified on Tuesday, 10 May 2016 07:52

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