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Continuity of care is essential to managing kidney disease

11 March 2021

World Kidney Day may not be as widely acknowledged as other disease awareness campaigns, but it certainly deserves our attention. Kidney disease, is a silent disease in the early stages, meaning diagnosis is often late and can result in life-long complications that require dialysis as a last resort. On March 11th, the global World Kidney Day initiative aims to raise awareness of the importance of our kidneys and keeping them healthy. The organisation behind World Kidney Day also aims to raise awareness around preventive behaviors, risk factors, and how to live with kidney disease.

Kidney disease is caused when damage occurs to the kidney’s blood vessels, which affects their ability to function properly. The most common cause of this damage is from diabetes, obesity, and hypertension. With such a high prevalence of the comorbidities directly contributing to its prevalence, kidney disease rates are believed to be increasing at an alarming rate in the UAE.

The most common type of kidney disease, affecting between 3 and 5% [1] of the UAE population, is chronic kidney disease. It is a complex disease that is long-term and doesn’t improve over time. Chronic kidney disease sees the gradual loss of kidney function as a result of damage that can be caused by a number of different conditions, with the most common contributor being diabetes. Managing the disease can be difficult and if the damage gets worse over time, the kidneys can fail completely, leaving the patient dependent on life-long dialysis or requiring a transplant. According to the Emirates Nephrology Society, around 1,600 people in the country undergo regular dialysis, and concerningly, this is increasing year on year.

With as many as one in ten adults[2] globally suffering from chronic kidney disease, learning to manage such a serious and long-term illness can present a challenge to the patient, and those close to them. Whilst patients can undergo many aspects of normal life without hindrance, treatment pathways of such complex conditions are unique and often, long-term. Patients may need to manage numerous doctor visits, nurse follow-ups, and potentially dialysis. Regular tests, assessments and counselling, performed by a range of caregivers at many different facilities, will become a normal part of life and are essential to maintaining kidney function and reducing the risk of disease progression.

The theme for World Kidney Day (WKD) in 2021 is ‘living well with kidney disease’, with the organisers turning the focus this year to the effective management of symptoms and enabling patient empowerment. Addressing the impact that living with a chronic disease has on the patient and their quality of life is a priority for the UAE’s leadership and addressing life-style related disease remains a key performance indicator of the UAE National Agenda.

An integral part of Abu Dhabi’s commitment to its many patients living with kidney disease, is the role of the health information exchange platform, Malaffi. Malaffi is a technology that allows healthcare providers to safely and securely, access and share a patient’s important, up-to-date medical record. Previously, the information and results obtained at each patient visit were not easily shared and had to be physically tracked down and requested, interrupting the care continuum. Continuity of this type of long-term care is extremely important and can have a direct impact on successful management of the disease and improving the patient’s quality of life. In response to the theme of WKD 2021 – continuity of care really does help patients to ‘live well with kidney disease’.

Further explaining the vital role that data sharing has in the management of kidney disease, Dr Maisa Abdalla, General Practitioner, Urgent Care Facility, Kanad Hospital, explains how the health information exchange is critical in patients admitted to hospital with underlying conditions.

“If a patient is admitted to hospital, and medical teams aren’t aware of their medical history and underlying conditions such as kidney disease, medication can be given in error and have severe consequences. In particular, patients who suffer from chronic kidney disease often experience severe complications when prescribed relatively common medications, such as antibiotics and anti-inflammatories. This interaction can cause acute kidney injury, also known as acute renal failure, which is a sudden episode of kidney damage as a result of various factors including an adverse drug interaction, and accounts for around 40% of all acute kidney injuries [3] seen within hospitals.

“With access to a patient’s important medical history and having detailed information on chronic conditions such as kidney disease and diabetes, medical teams can avoid potentially dangerous interactions. As an example, I recently saw a young patient that complained of abdominal pain, yet she did not report any pre-existing medical conditions. When I checked Malaffi, I saw that she had previously been diagnosed with chronic kidney disease. Having access to this information prevented me from prescribing a pain killer that would have made her condition worse. Instant access to the patient's medical history empowered me to make safe decisions, provide the best possible care to the patient and supports the continued, effective management of care for patients with chronic diseases.”

Dr Siddiq Anwar, Consultant Nephrologist, Abu Dhabi Health Services Company - SEHA

Acute Kidney Injury (AKI) in hospitals is common and expensive to manage. In addition, if the elderly and those with cardiovascular risk factors such as diabetes develop AKI they are at subsequent risk of recurrent AKI and progressive renal failure.

Presentation of kidney disease in the UAE is very different compared to the West due to our unique demographics. Hence, local data is needed to design our renal care and to optimise renal healthcare delivery here in UAE.

Malaffi with its bigdata collated from all Abu Dhabi healthcare providers can help us advance our knowledge in hospital AKI and help us to develop local solutions to local problems.

We at SEHA look forward to engaging with Malaffi and our regional stakeholders to help the DOH improve healthcare in the Emirate of Abu Dhabi with data-driven decisions.

Dr Rahul Goyal, Senior Vice President of Clinical Engagement and Adoption, Malaffi

“At Malaffi we are committed to supporting the Department of Health and tackling the most pressing healthcare needs in our community, including the burden of chronic disease. Malaffi supports our healthcare teams as they work tirelessly to help patients with chronic diseases such as chronic kidney disease to manage their conditions and improve their quality of everyday life. As well as supporting the continuity of management of diseases, Malaffi will assist the Department of Health to perform population health analytics to address the challenge of chronic and lifestyle conditions. As part of the digital transformation of the healthcare system in the Emirate, technology will increasingly have a role in predicting disease patterns, reducing risk factors, improving prevention and ultimately, improving quality of life.”

References:

[1] (PDF) Chronic kidney disease in patients at high risk of cardiovascular disease in the United Arab Emirates: A population-based study (researchgate.net)
[2] Global Facts: About Kidney Disease | National Kidney Foundation
[3] Hospital-acquired acute kidney injury in medical, surgical, and intensive care unit: A comparative study (nh.gov)

 

This article was published on Omnia Health and can be found here

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