Chronic Kidney Disease Management – What Can We Learn from South African and Australian Efforts?

Abstract

Background: The prevalence of chronic kidney disease is on the rise. Our objective is to describe two programs to improve the awareness and management of hypertension, renal disease, and diabetes in remote Australian Aboriginal and urban and periurban South African communities. We focus on how the Australian Aboriginal and South African Chronic Disease Outreach Programs have worked together. Methods: The establishment of prevention programs in developing countries is a challenge. The paper evaluates these challenges, including accessing international aid. The programs advocate that regular integrated checks for chronic disease and their risk factors are essential elements of regular adult health care. Programs should be run by primary health workers, following algorithms for testing and treatment, and a backup provided by nurse coordinators. Constant evaluation is essential to develop community health profiles and adapt program structure. Results: Both programs are discussed, including how they are organized to deliver preventative and treatment strategies. The challenges and adaptations required are outlined. Conclusions: It is the aim of the international kidney commu- nity to prevent chronic kidney disease. The South African and Australian groups highlight the need for a systematic and sustained approach to the management of chronic diseases to achieve this goal.

Evidence for improved patient management through electronic patient records at a Central Australian Aboriginal Health Service

“…Females had higher rates of kidney disease and diabetes than males in this community, while males had higher rates of hypertension. These profiles are consistent with and exceed those published for other remote Aboriginal communities 3,4,11,12 …”

Screening for Proteinuria and Chronic Kidney Disease Risk Factors in Kinshasa: A World Kidney Day 2007 Study

“…This value is much higher than the 11% found in Bolivia [5] and the 8.7% in NHANES III [3], but lower than the 55, 35 and 26% observed in Tiwi islanders [23], South Africans [24] and among Zuni Indians [25], respectively. This discrepancy between studies may be due partly to various definitions (microalbuminuria vs. dipstick proteinuria) and criteria of selection (random vs. without random sample or/and high risk population vs. whole population) applied in each survey.…”

Indigenous health: update on the impact of diabetes and chronic kidney disease

“…The past 5 years have seen a flurry of research publications in the area of Australian indigenous health where one of the main barriers to improving health has been the remoteness and cultural diversity of many indigenous Australian communities [53][54][55]. Australian researchers and communities have worked to improve healthcare access as a way of bridging gap in health outcomes.…”