Interventions for Chronic Kidney Disease

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Age Cohort: 60+ years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate community members 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 in safe place Proper follow-up and treatment compliance for chronic diseases like diabetes, hypertension, etc.	Recognition of renal diseases signs and symptoms	Exercise, healthy weight Appropriate salt and protein intake Smoking cessation Protein restriction Immediate transfer CKD cases to a higher-level health care facility	Home based renal rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
Educate community members on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs and trauma	Avoid nephrotoxic medicines and traditional herbs Proper control of chronic diseases like diabetes, hypertension, etc.	History Physical examination Complete blood count Urine protein test	Therapeutic life modification: exercise, healthy weight, Smoking cessation Appropriate salt and protein intake Antihypertensive medications (renin-angiotensin inhibitors) Glycaemic control Smoking cessation Protein restriction Correct anaemia	Renal rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Patient education on hypertensive and diabetic patients about the symptoms and signs of CKD	Avoid nephrotoxic drugs Proper control of chronic diseases like diabetes, hypertension, etc.	History Physical examination Complete blood count Basic metabolic panel Glomerular filtration rate (GFR) test Urine protein test X-ray Ultra sound	Treat reversible causes of CKD Smoking cessation Protein restriction Control Hypertension Control proteinuria Control hyperlipidaemia Control metabolic acidosis Correct anaemia	Renal rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Patient education on hypertensive and diabetic patients about the symptoms and signs of CKD		History Physical examination Complete blood count Basic metabolic panel X-ray, Ultra sound Computed tomography (CT) Magnetic resonance imaging (MRI)	Haemodialysis Peritoneal dialysis Kidney transplantation (living or deceased donor)	Renal rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families

Age Cohort: 12 - 24 years

Health Promotion	Disease Prevention	Diagnostic	Curative	Rehabilitative	Palliative
Community Level
Educate community members 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 in safe place Proper management and monitoring of chronic diseases like diabetes	Recognition of chronic kidney disease signs and symptoms	Encourage exercise, achieve a healthy weight and stop smoking Advise on appropriate salt and protein intake Smoking cessation Protein restriction Immediate transfer CKD cases to a higher-level health care facility	Home based renal rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to other relevant sectors for economic support/empowerment
Primary Care
Educate community members on measures to prevent kidney injuries and infections by avoiding excessive dehydration, misuse of drugs and trauma	Avoid nephrotoxic medicines and traditional herbs Effective treatment of malaria and other infections Close monitoring of chronic diseases like diabetes	History Physical examination Complete blood count Urine protein test	Therapeutic life modification: exercise, achieve a healthy weight and stop smoking Appropriate salt and protein intake Antihypertensive medications (renin-angiotensin inhibitors) Glycaemic control Smoking cessation Protein restriction	Renal rehabilitation: exercise training, diet & fluid management, medication & medical surveillance, education, psychological & vocational counselling	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to other relevant sectors for economic support/empowerment
Referral Facility: General
Patient education and counselling patients with congenital kidney disease, hypertensive and diabetic patients about the symptoms and signs of CKD	Early screening and identification of congenital kidney diseases Adjusting drug doses Avoid nephrotoxic drugs Effective control of chronic diseases like diabetes, hypertension, etc	History Physical examination Complete blood count Basic metabolic panel Glomerular filtration rate (GFR) test Urine protein test X-ray Ultra sound	Treat reversible causes of CKD Smoking cessation Protein restriction Control Hypertension Control proteinuria Control hyperlipidaemia Control metabolic acidosis	Renal rehabilitation: exercise training, diet & fluid management, medication & medical surveillance, education, psychological & vocational counselling	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to other relevant sectors for economic support/empowerment
Referral Facility: Specialist
Patient education and counselling patients with congenital kidney disease, hypertensive and diabetic patients about the symptoms and signs of CKD	Early screening and identification of congenital kidney diseases Adjusting drug doses Avoid nephrotoxic drugs Effective control of chronic diseases like diabetes, hypertension, etc.	History Physical examination Complete blood count Basic metabolic panel X-ray Ultra sound Computerized tomography (CT) scan Magnetic resonance imaging (MRI)	Haemodialysis Peritoneal dialysis Kidney transplantation (living or deceased donor)	Renal rehabilitation: exercise training, diet & fluid management, medication & medical surveillance, education, psychological & vocational counselling	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Linkage to other relevant sectors for economic support/empowerment