Interventions for Renal Injury (acute renal failure)

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Age Cohort: < 5 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate children to avoid wild kicking, falling when playing * Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Avoid nephrotoxic medicines and traditional herbs Early treatment seeking for malaria and other infections Keep drugs and harmful substances away from the reach of children Safe environment for children to play		Early recognition of kidney disease symptoms such as fever, flank pain, scanty/coloured urine and seek health care early Early treatment of malaria and other infections * Avoid nephrotoxic medicines and traditional herbs
Primary Care
Educate children to avoid wild kicking, falling when playing * Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Early recognition of kidney disease symptoms Avoid nephrotoxic medicines and traditional herbs Safe environment for children to play		Early recognition of kidney disease symptoms Early treatment of acute febrile illnesses such as malaria * Advice on adequate hydration
Referral Facility: General
Educate children to avoid wild kicking, falling when playing * Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Early recognition of kidney disease symptoms and seek health care early * Avoid nephrotoxic medicines and traditional herbs Safe environment for children to play		Laboratory investigations such as urine, blood to diagnose the underlying diseases * Treat early treatable urinary tract infections and other febrile illnesses * Adequate hydration, In case of kidney trauma, toxicity and overdose of medicines stabilize and refer to the next level
Referral Facility: Specialist
Educate children to avoid wild kicking, falling when playing Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Implement measures such as adequate hydration, Early recognition of kidney disease symptoms such as fever, flank pain, scanty/coloured urine and seek health care early * Avoid nephrotoxic medicines and traditional herbs Safe environment for children to play		Laboratory investigations such as urine analysis, renal function tests Basic Imaging modalities (x-ray, contrast x-ray, ultrasound Advance imaging modalities( CT scan, MRI) Treat renal diseases according the diagnosis * Renal dialysis for acute and chronic renal failures * Surgical management for trauma to the kidneys

Age Cohort: 5 - 11 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs and trauma	Adequate hydration Avoid nephrotoxic medicines and traditional herbs Early treatment seeking for malaria and other infections Keep drugs and harmful substances away from children Safe environment for play		Early recognition of kidney disease symptoms such as fever, flank pain, scanty/coloured urine and seek health care early Early treatment of malaria and other infections
Primary Care
Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Early recognition of kidney disease symptoms Avoid nephrotoxic medicines and traditional herbs Safe environment for play		Early recognition of kidney disease symptoms Early treatment of acute febrile illnesses such as malaria * Advice on adequate hydration
Referral Facility: General
Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs	Adequate hydration, Early recognition of kidney disease symptoms and seek health care early * Avoid nephrotoxic medicines and traditional herbs Safe environment for play		Laboratory investigations such as urine, blood to diagnose the underlying diseases * Treat early treatable urinary tract infections and other febrile illnesses * Adequate hydration, In case of kidney trauma, toxicity and overdose of medicines stabilize and refer to the next level
Referral Facility: Specialist
Educate, parents, teachers, community on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs and trauma	Adequate hydration, Early recognition of kidney disease symptoms such as fever, flank pain, scanty/coloured urine and seek health care early * Avoid nephrotoxic medicines and traditional herbs Safe environment for play		Laboratory investigations such as urine analysis, renal function tests, Screen for congenital renal diseases Basic Imaging modalities (x-ray, contrast x-ray, ultrasound, Advance imaging modalities( CT scan, MRI) Treat renal diseases according the diagnosis * Renal dialysis for acute and chronic renal failures * Surgical management for trauma to the kidneys

Age Cohort: 25 - 59 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		Provide dietary advice including avoidance of high sodium and excessive protein intake; Advice on blood glucose and blood pressure control Early recognition of kidney disease symptoms of need for referral
Primary Care
*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		Provide dietary advice including avoidance of high sodium and excessive protein intake Advice on blood glucose and blood pressure control Early recognition of kidney disease symptoms of need for referral
Referral Facility: General
*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		History and physical examination Basic laboratory tests Advance laboratory tests Basic imaging: x-ray, ultrasound, Advanced imaging: CT scan, MRI Therapeutic lifestyle modifications Appropriate management of infections and other febrile illnesses Pharmaceutical management to prevent or decrease the rate of progression to end-stage renal disease Optimal management of comorbidities such as diabetes and other cardiovascular diseases Statin therapy to reduce the risk of cardiovascular events Avoid or reduce nephrotoxic medications Monitor and manage CKD complications including: anaemia, electrolyte imbalance, and malnutrition Early referral for peritoneal dialysis or haemodialysis
Referral Facility: Specialist
*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		History and physical examination Basic laboratory tests Advance laboratory tests Basic imaging: x-ray, ultrasound, Advanced imaging: CT scan, MRI Therapeutic lifestyle modifications Appropriate management of infections and other febrile illnesses Pharmaceutical management to prevent or decrease the rate of progression to end-stage renal disease Optimal management of comorbidities such as diabetes and other cardiovascular diseases Statin therapy to reduce the risk of cardiovascular events Avoid or reduce nephrotoxic medications Monitor and manage CKD complications including: anaemia, electrolyte imbalance, and malnutrition Early referral for peritoneal dialysis or haemodialysis Renal replacement therapy

Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		Provide dietary advice including avoidance of high sodium and excessive protein intake; Advice on blood glucose and blood pressure control Early recognition of kidney disease symptoms of need for referral
Primary Care
Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		Provide dietary advice including avoidance of high sodium and excessive protein intake Advice on blood glucose and blood pressure control Early recognition of kidney disease symptoms of need for referral
Referral Facility: General
Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		History and physical examination Basic laboratory tests Advance laboratory tests Basic imaging: x-ray, ultrasound, Advanced imaging: CT scan, MRI Therapeutic lifestyle modifications Appropriate management of infections and other febrile illnesses Pharmaceutical management to prevent or decrease the rate of progression to end-stage renal disease Optimal management of comorbidities such as diabetes and other cardiovascular diseases Statin therapy to reduce the risk of cardiovascular events Avoid or reduce nephrotoxic medications Monitor and manage CKD complications including: anaemia, electrolyte imbalance, and malnutrition Early referral for peritoneal dialysis or haemodialysis
Referral Facility: Specialist
Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs] Provision of IEC/BCC materials	Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol Adequate hydration Avoid nephrotoxic medicines and traditional herbs Monitor blood pressure, sugar and cholesterol levels through community screening services		History and physical examination Basic laboratory tests Advance laboratory tests Basic imaging: x-ray, ultrasound, Advanced imaging: CT scan, MRI Therapeutic lifestyle modifications Appropriate management of infections and other febrile illnesses Pharmaceutical management to prevent or decrease the rate of progression to end-stage renal disease Optimal management of comorbidities such as diabetes and other cardiovascular diseases Statin therapy to reduce the risk of cardiovascular events Avoid or reduce nephrotoxic medications Monitor and manage CKD complications including: anaemia, electrolyte imbalance, and malnutrition Early referral for peritoneal dialysis or haemodialysis Renal replacement therapy