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Abstract: TH-PO050

Point of Care Creatinine for Community-Acquired AKI in Africa: Study Design

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical‚ Outcomes‚ and Trials

Authors

  • Poulikakos, Dimitrios J., Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
  • Erekosima, Ibi, Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
  • Fakrogha, Prelador Ebi, University of Port Harcourt, Choba, Rivers State, Nigeria
  • Lewis, David M., Northern Care Alliance NHS Foundation Trust, Salford, Manchester, United Kingdom
  • Harry, Agiriye Agba Monima, Rivers State of Nigeria Government, Port Harcourt, Rivers State, Nigeria
  • Emem-Chioma, Pedro C., University of Port Harcourt, Choba, Rivers State, Nigeria
Background

Community acquired Acute kidney injury (AKI) is associated with adverse outcomes in low and middle-income countries due to delayed diagnosis and lack of universal health care coverage. Supported by the International Society of Nephrology, in a collaborative project between a UK renal centre and a renal centre and the primary care health board in Port Harcourt Nigeria, we evaluated point of care creatinine (POC Cr) technology using capillary samples (https://doi.org/10.1016/j.ekir.2022.03.022). This phase of the project is designed to evaluate the use of POC Cr in conjunction with a minimum bundle of AKI care in a large primary care health centre in Nigeria that does not provide renal function tests.

Methods

Attendances data for March 2022 were obtained from the Ozuoba Comprehensive Health Centre in Nigeria. A 2 stage, modified delphi process, will be used to reach consensus amongst primary and secondary care clinicians on clinical algorithm and minimum AKI bundle. We plan to screen with POC Cr 500 patients at risk (Figure 1) with the aim to detect > 100 AKI cases.

Results

Out of 4148 recorded patient attendances, (20.3% medical, 18.8% obstetrics and 60.8% paediatrics), 464 (11.1%) were acute requiring short admission and 19 patients were referred to the hospital. The first stage of the consensus process concluded that the minimum AKI bundle will include renal function testing, urine dipstick, IV fluids and/or antibiotics for 48 hours if required. The second stage will be performed at a workshop in Port Harcourt in 2022.

Conclusion

This study will assess the cost-effectiveness and clinical impact on outcomes of POC Cr as a triage screening tool in acute presentations in this low-resource primary setting in conjunction with a minimum care bundle.

Funding

  • Commercial Support –