0 by 25 Initiative - International Society of Nephrology

0by25 Initiative

0by25 new banner AKI pages

Acute Kidney Injury (AKI) is preventable and treatable

At the 2013 World Congress of Nephrology in Hong Kong, immediate past President of the International Society of Nephrology (ISN), Prof. Giuseppe Remuzzi, set out the organisation’s vision for a world in which no one dies of preventable and treatable acute kidney injury (AKI).

To achieve this ambitious goal, the ISN launced the 0by25 initiative which aims to eliminate preventable deaths from Acute Kidney Injury (AKI) worldwide by 2025.

Our aim is to call for globally applicable strategies that permit timely diagnosis and treatment of AKI for patients with potentially reversible diseases.

0by25 is a global initiative with a strong emphasis on developing countries in Africa, Asia, and Latin America with disadvantaged populations and poor access to care.

We are working to eliminate preventable deaths from AKI in three key ways:

Evidence

0by25 will provide compelling new evidence to demonstrate the global burden of AKI, especially in low and middle-income countries, with the aim of establishing AKI as a contributor to the Global Burden of Disease. 0by25 will compile existing and prospective data in order to better understand AKI’s prevalence and to improve diagnostic and treatment methods.

Awareness & Education

0by25 will promote increased awareness of AKI across the global healthcare community, predominantly through education and training. Targeted information and educational materials will be developed for a broad range of audiences, including healthcare professionals, patients and governments.

Action

0by25 will work with those most affected to develop a sustainable infrastructure to enable “need driven” approaches to education, training and care delivery. Through pilot projects, 0by25 will implement globally applicable strategies that permit timely diagnosis and treatment of AKI for patients with potentially reversible diseases.

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GLOBAL SNAPSHOT DATA NOW AVAILABLE!

OTHER PROJECTS:

AKI Global Survey

0by25 Pilot Feasibility Project

To donate to the ISN, including the 0by25 Initiative, please visit:

Acute Kidney Injury (AKI)

ACUTE KIDNEY INJURY BANNER

Thousands of people are still dying in vain of AKI, especially in less developed or emerging countries. AKI should no longer be a death sentence for these people. Nobody should die of preventable and treatable Acute Kidney Injury (AKI) by 2025!

G. Remuzzi, ISN Past President (2013-15)

Acute kidney injury (AKI), previously referred to as acute renal failure (ARF), is characterised by an abrupt loss of kidney function. If left untreated, the condition has a high risk of multiple organ failure and, potentially, death. The increasing prevalence of AKI in developing and developed countries is strongly associated with increased early and long term patient morbidity and mortality, as well as the subsequent development of chronic kidney disease (CKD).

AKI has become a major global healthcare challenge with an estimated 13.3 million cases every year. The burden is particularly high in developing countries, where the annual incidence is estimated to be 11.3 million cases. Of the estimated 1.7 million deaths per year caused by AKI globally, an estimated 1.4 million of those deaths occur in low- and middle-income countries.

In the developed world, the increased prevalence of AKI can be linked to an aging population burdened by multiple co-morbidities. Drug induced kidney injury is recognised as a major factor in about 20% of cases, while hospital acquired infections, sepsis, complex surgery and diagnostic procedures are also significant risk factors for development of AKI.

In developing countries, the causes of AKI and those most susceptible to the condition vary according to the healthcare setting. In modern, large, urban centers, AKI is very similar to that found in developed countries; it is predominantly a hospital-acquired condition occurring mostly in older, critically ill multi-organ failure patients with substantial comorbidity. In contrast, in rural areas or smaller cities in the countryside, AKI will often be a community-acquired disease, affecting younger and previously healthy individuals. Specific causes include diarrheal diseases with dehydration, infectious diseases (malaria, dengue, yellow-fever, tetanus and HIV), animal venoms (snakes, bees, spiders), septic abortion, dyes and natural medicines. Most of these factors are associated with poverty and affect vulnerable populations due to poor sanitation and water hygiene, a lack of education and poor access to the healthcare system.

AKI is preventable and treatable often with few, if any, long-term health consequences. However, the lack of early identification and treatment in many countries – both in the developing and developed world – means that patients often don’t receive essential care before it is too late.

The 0by25 initiative aims to eliminate preventable deaths from Acute Kidney Injury (AKI) worldwide by 2025. To achieve this ambitious goal, the mission is to call for globally applicable strategies that permit timely diagnosis and treatment of AKI for patients with potentially reversible diseases. This is a global initiative with a strong emphasis on developing countries in Africa, Asia, and Latin America with disadvantaged populations and poor access to care.

Projects

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One of our key aims is to foster the training and education of healthcare workers in low resource settings; their effectiveness in detecting and treating AKI is a crucial part of our strategy. We are also exploring the great potential of telemedicine and near patient testing to empower village health workers in these underdeveloped regions.

John Feehally & Nathan W. Levin, 0by25 Operations Group Members

For more information on the projects carried out under the 0by25 Initiative, click on the tabs below:

AKI GLOBAL SURVEY

As a first step, in 2014, we developed the AKI Global Survey. We asked more than 10,000 nephrologists around the world to tell us how AKI is diagnosed and treated in their respective countries.

Our aim was to gain a better understanding of the way AKI is managed globally and also to identify appropriate research settings for future 0by25 projects, specifically the AKI Global Snapshot.

The AKI Global Survey was launched eight different languages:

Arabic Version: www.0by25.org/census/ar
Chinese Version: www.0by25.org/census/ch
English Version: www.0by25.org/census/en
French Version: www.0by25.org/census/fr
Japanese Version: www.0by25.org/census/jp
Portuguese Version: www.0by25.org/census/pr
Russian Version: www.0by25.org/census/ru
Spanish Version: www.0by25.org/census/sp

AKI GLOBAL SNAPSHOT

Global AKI Snapshot logo

The Global Snapshot is a prospective, cross-sectional, global cohort study designed to better understand the growing burden of AKI, including how it is identified, managed and treated in different settings around the world.

The study, which was carried out in late-2014, included over 4000 patients from more than 72 countries and has generated exciting new data on the global burden and management of AKI.

ISN is proud to share this data with the nephrology and wider healthcare community.

On 13 April 2016, the main findings of the Global Snapshot were published in The Lancet! The publication is authored by Dr. Ravindra Mehta, ISN 0by25 Director, and our dedicated 0by25 team of senior ISN members and AKI experts.

More information on the Global Snapshot results is available HERE

CLICK HERE to read a short article on tackling Acute Kidney Injury worldwide by 0by25 Director, Dr Ravindra Mehta, on the The Lancet Kidney Campaign website.

GLOBAL SNAPSHOT PARTICIPATING CENTERS

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0by25 PILOT FEASIBILITY PROJECT

The 0by25 Pilot Feasibility Project is a major focus for the 0by25 initiative in 2016-2017 and is directed towards establishing a sustainable infrastructure for prevention, education and training, detection and management of AKI, which can be implemented according to local needs and resources.

The objectives of the 0by25 Pilot Feasibility Project are:

assess the feasibility of implementing interventions to optimize education, training and care of AKI based on a comprehensive 5R approach
determine the barriers for the recognition and management of AKI in different settings
compare outcomes from AKI before and after interventions
establish a network of stakeholders across the world to raise public awareness of AKI.

ISN will implement the project in 3 selected clusters located in Africa, Asia and Latin America. Each cluster may include 4 to 6 health care clinics providing care for the local community, 1-2 regional hospitals and 1 referral hospital.

Initial results from the 0by25 Pilot Feasibility Project are expected to be available by ISN World Congress of Nephrology (WCN) 2017 in Mexico.

ISN 5R APPROACH TO THE MANAGEMENT OF AKI

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SAVING YOUNG LIVES PROJECT

Through the Saving Young Lives Project, ISN seeks to develop sustainable programs for treating acute kidney injury (AKI) in sub-Saharan Africa and South East Asia aimed at establishing and maintaining hospital centers for care of AKI including facilities for acute PD. The Saving Young Lives Project is run in partnership with leading international organisations IPNA (International Pediatric Nephrology Association), ISPD (International Society for Peritoneal Dialysis) and SKCF (Sustainable Kidney Care Foundation)

Click here to learn more about the Saving Young Lives Project!

Saving young lives

News & Publications

LATEST NEWS

July 2016

On 17-19 July 2016, at University of California, San Diego (UCSD) facilities, ISN is extremely pleased to have funded the first training of the Principal Investigators and Project Managers from the clusters in Bolivia, Malawi, Nepal and Tanzania which have been selected to take part in the ISN 0by25 Pilot Feasibility Project. The project is directed towards establishing a sustainable infrastructure for prevention, education and training, detection and management of AKI, which can be implemented according to local needs and resources.

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From left to right, Dr. Ravi Mehta, 0by25 Director and leading Principal Investigator from UCSD, Dr. Karen Yeates and Dr. Erica Erwin, leading the Pilot Project in Tanzania, Dr. Etienne Macedo, Project Manager from UCSD, Dr. Victor Hugo Garcia-Carlo from Bolivia, Dr. Rakesh Malhotra from UCSD and Dr. Rolando Claure, leading the pilot project in Bolivia with Dr. Garcia-Carlo, Dr. Ulla Hemmila and Ms. Naomi Pleasant Sibale leading the project in Malawi, and Dr. Sanjib Sharma, Principal Investigator in Nepal.

June 2016

British Journal of Hospital Medicine, Clinical News: Recognition and management of acute kidney injury: a multinational cross-sectional study

April 2016

November 2015

ISN News 55 November 2015: Evidence, awareness … action!

March 2015

September 2014

ISN Press Release: The 0by25 AKI Global Snapshot is launched!

August 2014

ISN News 50 August 2014: 0by25 initiative update

November 2013

ISN News 47 November 2013: 0 by 25 – a human right case for health equity

Partners & Supporters

PARTNERS AND SUPPORTERS BANNER

The 0by25 initiative is managed and funded by the International Society of Nephrology (ISN). This work would not be possible without the generous support and contributions of our partners.

SUPPORTERS

We welcome the collaboration of colleagues working in the field of nephrology, together with the patient and broader healthcare community. By working together we will succeed in reducing the number of preventable and treatable deaths from AKI.

0by25 is endorsed by:

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OFFICIAL PARTNERS

We are particularly grateful to our partners for their financial contributions and ongoing support to the 0by25 initiative. Their engagement is invaluable in supporting our activities.

CONTACT US

If you would like to support the 0by25 initiative, please contact our team for further information:

Louise Fox, Senior Project Manager, [email protected]
Rik Bollaert, Business Development Director, [email protected]

Leadership & Team

LEADERSHIP AN TEAM BANNER

ISN’s global network and program of activities enables kidney experts from developed and developing countries to collaborate in the global fight against kidney disease. Inspired by Giuseppe Remuzzi, 0by25 Founder and Ambassador, the 0by25 initiative is led by Ravindra Mehta and supported by a dedicated 0by25 Administration Team and Operations Group

0by25 PROJECT ADMINISTRATION TEAM

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0BY25 OPERATIONS GROUP

Our dedicated Operations Group, formed of leading global nephrologists, is also responsible for the design and implementation of the core 0by25 work streams:

Gathering existing and prospective data on the burden of AKI
Developing information materials and toolkits
Implementing pilot projects

If you have any questions or wish to know more about 0by25, please contact:

Louise Fox, Senior Project Manager, email: [email protected]
Luisa Strani, Project Coordinator, email: [email protected]
Dominique Tudor, Project Assistant, email: [email protected]