![]() 3Įvery client receives risk-based kidney health counseling from the screening nurse immediately following testing. ![]() ![]() Pediatric (<18 years old) clients are triaged using a separate algorithm developed in collaboration with pediatric nephrologists and endocrinologists. Validated in more than 700,000 adults across 30 countries, the Kidney Failure Risk Equation predicts the 2- and 5-year probability of requiring dialysis or transplant for individuals whose estimated glomerular filtration rate was 60 ml/min per 1.73 m 2) as high, intermediate, or low risk. Once a client’s information is entered, the application automatically calculates their risk of progressing to end-stage kidney disease using the Kidney Failure Risk Equation. Client consents, demographic information, and clinical data are entered at the point of care onto an iPad using a secure, customized application designed specifically for Kidney Check. An additional blood sample (100 μL) is collected to analyze for hemoglobin A 1c and a urine sample is provided to determine the albumin-to-creatinine ratio on a DCA Vantage analyzer (Siemens, Erlangen, Germany). Pediatric Kidney Check screening process.įollowing registration, clients are brought to a designated screening area where a finger prick droplet sample (100 μL) is collected and analyzed for creatinine on an i-STAT Alinity analyzer (Abbott Point of Care Inc., Princeton, NJ). As an affiliate of the CanSOLVE CKD network, members of all committees within Kidney Check have linkages to the broader network. Stationed in various communities across the country, the team’s primary aim is to accommodate high throughput while maintaining quality control (QC) standards. Screening teams operate under the auspices of the Diabetes Integration Project and First Nations Health and Social Secretariat of Manitoba (FNHSSM). They are supported by the patient partner committee that oversees the execution of knowledge translation activities including but not limited to community selection criteria, community engagement procedures, and review of communication materials and strategies. Largely composed of Indigenous stakeholders and closely affiliated with the CanSOLVE CKD Indigenous People’s Engagement Council (IPERC), the advisory committee provides valuable insight on how to best use engagement strategies to maximize participation in the screening event. This includes working closely with the advisory committee to preemptively identify potential barriers and risk issues in order to develop efficient mitigation strategies. Leadership provides guidance to the provincial teams to ensure the appropriate objectives, processes, and tools are in place to support high-functioning groups. Kidney Check’s management structure consists of the leadership team, advisory committee, patient partner committee, and mobile screening teams. The intent of this manuscript is to describe the development process of all procedures and components related to the deployment of the Kidney Check program with specific focus on organizational structure, point-of-care testing devices, and data management. To ensure the efficacy and sustainability of the program, Kidney Check relies on a strategic quality management system that addresses all aspects of the screening process. Modeled after the 2015 FINISHED initiative in Manitoba, 3 and working within the CanSOLVE CKD network ( Kidney Check employs point-of-care testing (POCT) to identify CKD, diabetes, and hypertension in individuals aged 10 and up regardless of preexisting risk factors. ![]() Kidney Check is a comprehensive screen, triage, and treat initiative working to bring preventive kidney care to rural and remote Indigenous communities across Manitoba, Ontario, British Columbia, Alberta, and Saskatchewan. ![]() Of these, chronic kidney disease (CKD), diabetes, and hypertension are highly prevalent, reaching epidemic levels in many communities. 1 In Canada, this manifests in disproportionately high rates of chronic disease, often diagnosed at a younger age and greater severity than non-Indigenous groups. In many cases, Indigenous groups are isolated from mainstream health care services (geographically, economically, or culturally) and lack the preventive health benefits associated with continuity of care. Indigenous peoples often endure significant health disparities fueled by historic and ongoing marginalizing policies and practices. ![]()
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