Chronic Kidney disease
Conditions
Interventions
Study setting: All primary and secondary care government health institutions in Gampaha district
Randomization: Block randomization.
Number of arms in the study: Study contains two arms, interventi
Sponsors
Department of Public Health, Faculty of Medicine University of Kelaniya
Eligibility
Inclusion criteria
Inclusion criteria: All the medical officers in the Gampaha district conducting family medical clinics and medical clinics conducted by VP OPD and general physicians.
Exclusion criteria
Exclusion criteria: Intern medical offices Medical officers who conduct diabetic clinics or endocrinology clinics headed by consultant endocrinologists , cardiology clinics headed by consultant cardiologists , nephrology clinics headed by consultant nephrologists
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Primary outcome will be detected /assessed by presence of documentary evidence in clinic books of patients following three months of implementation. Presence of all five steps are expected to present in the clinic book to consider as proper detection of CKD. 1.1 Presence of documentary evidence of ordering of serum creatinine and proteinuria (either UFR , ACR, UPCR) or using an available serum creatinine value done within past nine months duration. 1.2 Conversion of serum creatinine into eGFR using a formula with the help of a given table ,APP (computer soft wear) , calculation by themselves ) or using laborotory reported values 1.3 Staging of CKD according to eGFR category(interpretation of eGFR) ,If there is a impairment in eGFR , planning to repeat the eGFR in 3 months . 1.4 Interpretation of proteinuria value and planning to repeat the test in three months 1.5 Documentation of renal function status as no renal impairment or stage of CKD if there is renal impairment according to eGFR category or proteinuria category or both . [Three months after implementation of intervention] | — |
Secondary
| Measure | Time frame |
|---|---|
| Presence of documenatary evidence for provision of minimum three or more of following evidence based management measures for patients according to their need after the date of intervention will be taken as improved provision of care. 1.1 Addition of ARB or ACEI if not added 1.2 Addition of a statin if not added 1.3 Ordering a Lipid profile if not done for the fast one year 1.4 If LDL is > 100 mg /dl , reporting it as high and giving nutritional and exercise counselling. 1.5 Measuring blood pressure and documentation as high (if BP > 140/90 ) for the disease status and giving nutritional and exercise counseling 1.6 If there is poor glycemic control adjustment of drugs ( addition of a new drug or increasing the dosage ) or giving dietary counseling 1.7 Referral to a nutritionist if necessary 1.8 If smoking is present ,mentioning it as a smoking positive and giving counseling for no smoking 1.9. Writing a referral to the nephrologist following renal status assessment if needed. Presence of documentary evidence in the clinic books is expected [Three months after implementation of intervention] | — |
Countries
Sri Lanka
Contacts
Public ContactDr. Ramya Hettiarachchi
Registrar in Community Medicine
Outcome results
None listed