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Prevention of Treatable Acute Kidney Injury (AKI)

In 2013, at the World Congress of Nephrology, the International Society of Nephrology made the vision statement for the world to prevent deaths due to treatable acute kidney injury (AKI). Each year there were 13.3 million reported cases of AKI, with developing countries burdened with approx 11.3 million. Working towards this ambitious project, International Society of Nephrology launched the #0by25 campaign, to reduce preventable deaths from AKI across the world by the year 2025. The aim was to create global strategies for early diagnosis and treatment of AKI among patients with reversible diseases. 

This initiative focused on bringing in infrastructure, training and education through need based projects. These were particularly designed to meet the needs of developing countries and disadvantaged populations. 

In August of 2018, a path breaking Pediatric Critical Care Nephrology and Dialysis course was organized by Dr Sidharth Sethi, Consultant Pediatric Nephrologist, Medanta Hospital. Focus of the conference was #0by25kids – AKI. The conference was designed with work stations where many young intensivists, doctors and grooming medical residents were familiarized with handling peritoneal dialysis, fluid restrictions, and neonatal catheterisation.

It was here that Ms. Vasundhara Raghavan was aroused by this prospect of saving kids from preventable and treatable AKI. 

Within a few days Kidney Warriors Foundation was approached for help, in a case where a fourteen year old was affected by AKI. The teenager’s case was at a critical stage as he was also detected with Liver Cancer. 

Young Harshavardan’s case received urgent attention. Saving his kidneys seemed to be of highest priority. Within the next five days KWF was able to raise Rs 1 lakh for his Continuous Renal Replacement Therapy (CRRT). CRRT is a slow and continuous dialysis treatment that is done with expensive equipment, owned by some larger hospitals in the country. Each day’s treatments are approximately Rs 30,000 or more.

In 2019, KWF heard through friends in Chandigarh that there was a long wait list for kids to receive treatment due to shortage of equipment. We visited Postgraduate Institute of Medical Education and Research – APC PGIMER, Chandigarh and understood their urgent requirement. Several kids, with diarrhea, snake bites were waiting for their turn to be saved. 

It was a momentous decision to use funds received through Mrs Usha Uthup to bring relief to kids and save so many lives. 

To understand how much effort was directed towards #0by25-AKI, Dr Kanav Anand, Consultant Pediatric Nephrologist, Sir Gangaram Hospital was contacted. He shared some steps taken by pediatric nephrologists. To create awareness, lecture series emphasising upon treatment possibilities were planned in neighbouring cities. The forums encouraged pediatricians to give emergency dialysis to treat renal diseases promptly and prevent long-term complications. The talks also generated ideas of getting equipped with peritoneal dialysis machines as the first point of emergency treatment.

From Maharashtra Dr Uma Ali, with her NGO, Kidney Foundation for Children conducted outreach programmes with other pediatric nephrologists to educate pediatricians to recognize and manage AKI with workshops on acute peritoneal dialysis. 

KWF has made #0by25-AKI as their mission, as saving kids from agonizing treatments of lifelong kidney failure, was too important an aspect of prevention programmes to be ignored. Association could be through workshops or saving individuals as opportunities present themselves.

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