Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Author Reply
Book Review
Brief Communication
Case Report
Case Series
Clinical Case Report
Clinicopathological Conference
Commentary
Corrigendum
Editorial
Editorial – World Kidney Day 2016
Editorial Commentary
Erratum
Foreward
Guidelines
Image in Nephrology
Images in Nephrology
Letter to Editor
Letter to the Editor
Letters to Editor
Literature Review
Notice of Retraction
Obituary
Original Article
Perspective
Research Letter
Retraction Notice
Review
Review Article
Short Review
Special Article
Special Feature
Special Feature - World Kidney Day
Systematic Review
Technical Note
Varia
View/Download PDF

Translate this page into:

Varia
26 (
1
); 69-69
doi:
10.4103/0971-4065.167278

Act faster for your chronic kidney disease patients

Department of Nephrology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
Address for correspondence: Dr. A. K. Dey, 604/D, Phase 10, New Golden Nest, Sonam Sagar Co-operative Housing Society, Mira Bhayander Road, Bhayander (East), Thane - 401 105, Maharashtra, India. E-mail: ayankumardey911@gmail.com
Licence

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

Since the time Louis Vincent invented the concept of FAST HUG,[1] there has been a huge impetus provided in the management of critically ill patients. It has also seen a rise in the extension of the mnemonic to FAST HUG BID[2] and others, which has definitely provided a quick way to screen critically ill patients in the busy wards.

With the advent of better diagnostic modalities and better understanding of renal physiology over the years, there has been a growing need to look at all the aspects of patient care in the management of chronic kidney patients presenting to the nephrologist. In the process, there may be cases where priority may be given to only certain aspects of care.

We introduce a mnemonic called ACT FASTER that would enable the treating unit to look at all the aspects of patient care. The mnemonic allows identification of key aspects of the care of all chronic kidney disease (CKD) patients, especially those in Stage 5. It can be used during ward rounds, and may go a long way in the general management of our cases.

  • A: Anemia status; hemoglobin, transferrin saturation, ferritin, and other relevant reports.

  • Review of erythropoietin and iron doses.

  • C: Calcium, phosphorus, Vitamin D level, iPTH levels, and mineral bone disease status.

    Adjustment of medications.

  • T: Treatment review, drug dose adjustments if needed.

  • F: Food and nutrition review. May involve dietitian feedback.

  • A: Access creation and current access status with any complications.

  • S: Serology status (if on hemodialysis [HD]) and vaccination status.

  • T: Treatment of other co-morbid conditions such as diabetes mellitus and hypertension.

    Review of medications for optimization of control.

  • E: Exclusion of reversible factors if suspected.

    (e.g., prerenal causes, postrenal causes, nephrotoxics, myeloma, vasculitis, etc.).

  • R: Renal size and echotexture, other relevant renal imaging results.

    Renal biopsy report review, if available.

Application of this simple strategy will encourage teamwork and may help improve the quality of care received by CKD patients. Further studies including a big cohort of patients can be undertaken to look into the impact of such strategy and its utility for patient management.

References

  1. , . Give your patient a fast hug (at least) once a day. Crit Care Med. 2005;33:1225-9.
    [Google Scholar]
  2. , , . Critically ill patients need “FAST HUGS BID” (an updated mnemonic) Crit Care Med. 2009;37:2326-7.
    [Google Scholar]

    Fulltext Views
    49

    PDF downloads
    28
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections