The importance of early referral
Fresenius Medical Care Indonesia was pleased to again sponsor this year’s 14th Jakarta Nephrology and Hypertension Course & Symposium at the Ritz Carlton Hotel from 2nd – 5th of May 2014. With the theme “Update in Chronic Kidney Disease (CKD)”, the goal of the event was to disseminate and exchange scientific and practical knowledge in the field of nephrology and hypertension among more than 500 doctors, nurses and other health care professionals.1
One of the scientific highlights included Fresenius Medical Care’s sponsored talk – “Indication of Dialysis Initiation in Chronic Kidney Disease” by Prof. Dr. Emma Syarifih Moeis, Sp.PD-KGH who shared her insights about the significant increase of CKD patients who need renal replacement therapy (RRT) in Indonesia. Concluding that kidney function should be maintained optimally including RRT preparation, she also summarised that the decision for dialysis initiation should be based on clinical assessment.2
A review of 27 longitudinal cohort studies by Smart NA, Titus TT, titled “Outcomes of early versus late nephrology referral in chronic kidney disease: a systematic review” displayed a similar outcome. The authors searched in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE up until September 2008 for studies of early versus late nephrology referral in adult patients (>18 years) with chronic kidney disease with early referral defined by the time period at which patients were referred to a nephrologist. They found that of the 17,646 participants, 66.5% were referred early and 33% were referred late resulting in a higher mortality of those referred late to a specialist3 supporting the conclusion of Prof. Dr. Emma Syarifih Moeis.
In Indonesia, the number of CKD patients is growing rapidly. One contributing factor is the growth of diabetes and hypertension. Around 1 in 3 people in Indonesia suffers from hypertension.4 Figure 1.0 below shows that in 2013, 8.5 million people in Indonesia between the ages of 20-79 years lived with diabetes while another 4.6 million in the same age bracket were undiagnosed.5 The World Health Organisation estimates that Indonesia will rank as the fourth most prevalent country worldwide to fall to the global diabetes problem. By 2030, 21.3 million Indonesians6 are predicted to suffer from diabetes raising concerns about how the government will cope with the health burden.
Addressing the need for RRT, Fresenius Medical Care Indonesia presented their 4008S Next Generation haemodialysis treatment approach which allows healthcare professionals to utilise the benefits of cardioprotective haemodialysis. Its key features include:
- Monitoring of dialysis dose by OCM® (Online clearance monitoring and plasma sodium measurement)
- Treatment with ultrapure dialysis fluid (DIASAFE®plus filter)
- Use of hygienic, dry bicarbonate concentrate (Bibag®)
- Single-needle method
- Connection for central concentrate supply7
For more information about the 4008S Next Generation, please click here.
During the event, Fresenius Medical Care Indonesia also showcased their renal online platform www.fmc-id.com whilst announcing the news that their Bahasa renal platform will be launched soon - reaching an even broader audience. The website supplies information for healthcare professionals and patients alike including latest news articles, event information, patient focused programs and so much more! Healthcare professionals can also stay up-to-date with the latest topics by signing up to the Fresenius Medical Care Connect quarterly e-newsletter.
- PERNEFRI (2014). Preface for the 14 Jakarta Nephrology and Hypertension Course & Symposium on Hypertension; accessed May 2014.
- Scientific Table; The 14th Jakarta Nephrology and Hypertension Course & Symposium on Hypertension: Indication of Dialysis Initiation in Chronic Kidney Disease, Saturday 3rd May, 11:20am.
- Smart NA, Titus TT; Outcomes of early versus late nephrology referral in chronic kidney disease: a systematic review. PubMed Am J Med. 2011 Nov; 124 (11):1073-80.e2. doi: 10.1016; accessed May 2014.
- Rahajeng E, Tuminah S. Prevalence of Hypertension and Its Determinants in Indonesia, Journal of Indonesian Medical Association, 2009, 59 (12): 580-587.
- International Diabetes Federation; IDF Diabetes ATLAS, Sixth Edition, 2013.
- Wild S, Roglic G, Green A et al. Global Prevalence of Diabetes; Diabetes Care, 2004 vol 27: no 5.
- Fresenius Medical Care Indonesia; accessed May 2014