Strategies to support regulation and quality assurance will need to be developed in local contexts and guidance, as outlined elsewhere.37 Establishing a credible case for CKD detection and management based on risks, interventions and outcomes, and costs, based on real-world data, will help to translate theoretical cost-effectiveness (currently established primarily in high-income countries with minimal data from elsewhere) into economic reality.30,38 Screening should include evaluation of risk factors for CKD, eliciting a family history, recognizing potential symptoms (usually advancedfatigue, poor appetite, edema, itching etc.), and measuring blood pressure, serum creatinine, urinalysis, and urine albumin/protein to creatinine ratios, as outlined in established guidelines.19,39 Addressing CKD upstream beginning in primary care should lower costs over time by reducing CKD complications and KF
Advances in Complementary & Alternative Medicine
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