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Towards renal health equity: the ISN GO programs

Towards renal health equity: the ISN GO programs. Bogdan Ene-Iordache Sergio Carminati Norberto Perico Giuseppe Remuzzi Andrea Remuzzi Mario Negri Institute Ranica (BG), Italy. Introducing ISN Global Outreach Research & Prevention Programs.

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Towards renal health equity: the ISN GO programs

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  1. Towards renal health equity: the ISN GO programs Bogdan Ene-Iordache Sergio Carminati Norberto Perico Giuseppe Remuzzi Andrea Remuzzi Mario Negri Institute Ranica (BG), Italy

  2. Introducing ISN Global Outreach Research & Prevention Programs Tailor-made research projects and early detection strategies in low to middle income countries with involvement of local health workers and authorities • In the developed world, medicine is developing evidence for non-communicable chronic disease including the cardiovascular and kidney diseases, but has no equity plans • Chronic non-communicable diseases represent the major cause of morbidity and mortality worldwide, both in the developed and developing world • In this context, chronic kidney disease (CKD) plays a central role and represents a key element within the major chronic diseases • The ISN established the Global Outreach programs aimed at building global capacity for preventing CKD in emerging nations

  3. KHDC, a program for prevention of non-communicable chronic diseases • It helps to effectively set up and support early detection and intervention programs in low-to-middle income countries • The programs vary in size depending on the particular needs, organizational facilities and economic imperatives but are based on a common template that is tailored for the specific conditions of each country • Guidelines for evidence-based use of low-cost therapies in the prevention of CKD, cardiovascular diseases and their risk factors • Nephrologists from developing countries may apply for local KHDC programs at ISN GO Research commission • Potential projects are selected on a competitive basis twice a year: first 3 ranked projects in each round are awarded $15,000 grants for setting up the local program • MNI in Ranica is the coordinating center of the KHDC initiative

  4. The Kidney Disease Data Center (KDDC) Necessity of data management and surveillance of the ISN-awarded programs Aims: - monitoring of enrollment and follow-up of participants in KHDC programs - identification of subjects at high risk of adverse outcomes - assessment of feasibility of CKD screening in lower income settings Data Flow Local health communities Reports Data collection Web-based EDC

  5. KDDC Records 2005 -2011 70 61,161 60 50 45,143 40 29,933 30 23,728 DB records ( x 1000) 18,929 20 12,570 10 4,405 0 2011 2010 2005 2006 2007 2008 2009

  6. Burden of CKD, proteinuria, and cardiovascular risk among Chinese, Mongolian and Nepalese participants in the ISN Screening Programs • Impaired kidney function, proteinuria, and cardiovascular risk factors were detected in participants in the screening programs in Asian low- to middle-income countries • The diagnostic of abnormalities across these diverse settings suggests that trials of targeted screening and intervention are feasible and warranted in such countries Prevalence of HTN Cardiovascular risk by e-GFR & proteinuria Prevalence of proteinuria Sanjib KS et al., AJKD, 2010

  7. Discussion & Conclusions • The KDDC activities demonstrated the possibility of reliable assessment of risk factors for CKD in low to middle income countries and are suggesting that trials of targeted screening and intervention are feasible and warranted in such settings • ISN GO prevention programs provide opportunities for developing countries to have more competent nurses and doctors, as well as more clinical research and prevention programs, with better care • By making the knowledge of the developed world accessible in emerging countries the ISN GO programs and the KDDC are minimizing the gap between routine care in developing countries and the advanced research in kidney disease • Studies to lower these types of disparities are prerequisite for convincing decision makers to fund initiatives aimed at preventing CKD and its consequences

  8. These slides belong to: Bogdan Ene-Iordache bogdan@marionegri.it Mario NegriInstitute for Pharmacological Research Via G.B. Camozzi, 3 24020 Ranica, Italy Any use of these materials warrants pre-authorization. In case of doubt, we recommend that you request clarification from the author. Be aware that it may be authorized only by mentioning the source.

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