Abstract: TH-PO0987
Integrating Kidney Care in Noncommunicable Disease Prevention and Management Program at Primary Level: A Firsthand Experience
Session Information
- Diversity and Equity in Kidney Health
November 06, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Sharma, Sanjib Kumar, BP Koirala Institute of Health Sciences, Dharan, Province No. 1, Nepal
- Pyakurel, Anuj, KHDC Nepal, Dharan, Province No. 1, Nepal
- Adhikari, Nabin, Chatara Primary Health Center, Dharan, Province No. 1, Nepal
- Bhattarai, Urza, KHDC Nepal, Dharan, Province No. 1, Nepal
- Ghimire, Anup, BP Koirala Institute of Health Sciences, Dharan, Province No. 1, Nepal
- Gautam, Ujwal, BP Koirala Institute of Health Sciences, Dharan, Province No. 1, Nepal
Background
Contextual adaptations have been recommended in integrating kidney care to Non-Communicable Disease (NCD) focused programs. High burden of care for kidney disease could strain health systems in low- and middle- income countries (LMICs). Preventing adverse outcomes of kidney disease requires primary management of risk factors with focus on early detection through adequate resource allocation. This report presents a pioneer approach undertaken at a primary level setting in Nepal to deliver kidney care through an NCD clinic.
Methods
An NCD clinic was initiated at a primary level health center citing need to improve quality of services for chronic care patients. Institution-based screening of at-risk population are undertaken based on clinical evaluation, blood glucose estimation (Fasting blood glucose, HbA1c), serum creatinine, lipid profile, and urine analysis (albumin, creatinine, ACR). Diagnosed patients are provided with prescription medicines and put on a follow up schedule. Local health workers are trained in management protocols for kidney disease. All costs are covered by national health insurance program.
Results
958 patients with risk factors of NCDs were examined during the period from May 2024 to April 2025. Median (interquartile range) age of patients reporting to the clinic was 58 (48.8 – 68) years; 56.3% were female. 68% were diagnosed with hypertension; 36.3% with diabetes; 3 heart failure cases; 2 stroke cases. Of 14 proteinuria cases were identified, 2 were known cases of chronic kidney disease while 12 were new detections. Among newly detected proteinuria, 1 case each had stage 4 and stage 3 moderate kidney disease, respectively, and 6 cases had stage 2 early kidney disease while 4 had stage 1, respectively, based on eGFR staging. 11 out of 14 cases with proteinuria had a diagnosis of diabetes (p=0.001). 142 were subsequently examined at first follow up. Consecutive follow-ups were undertaken for 37 patients on second visit and further 11 cases for third visit.
Conclusion
Coordinated efforts that allow reorientation of existing resources with emphasis on primary and secondary strategies could be directed through NCD focused programs at publicly funded institutions for improving kidney care. Emphasis should be laid on improving treatment adherence and regular follow-up at health centers.