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Thailand: AI-Enabled Accessible Kidney Disease Screening

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In a major development for public health in Thailand, the National Nanotechnology Centre (NANOTEC-NSTDA) has unveiled two tests to address the escalating prevalence of chronic kidney disease (CKD). The AL-Strip and GO-Sensor Albumin Test, developed in collaboration with partner organisations, are poised to revolutionise CKD screening, making it more accessible and affordable for a more significant population segment.

Image credits: nstda.or.th

Chronic kidney disease, affecting approximately 10% of the global population, leads to one million deaths annually due to unaffordable treatment. The situation is particularly dire in Thailand’s northeastern region, where CKD prevalence stood at 17-22% in 2009, according to Thai SEEK data, and surged to 26% in certain areas in 2022, as reported by CKDNET. Most patients only become aware of their condition in stages 3-4, necessitating costly kidney dialysis treatments that can reach up to THB 200,000 per person annually. Timely detection prevents irreversible kidney damage through lifestyle modifications and medication.

Traditional CKD screening in Thailand has been prohibitively expensive, with costs ranging from hundreds to thousands of Baht, depending on the precision of the test. Moreover, these screening services are primarily available in well-equipped large hospitals or private laboratories, limiting accessibility for a significant portion of the population.

For instance, breast cancer screening by MTEC, NSTDA, Ramathibodi Hospital’s Faculty of Medicine, and a technical service company has unveiled a pioneering breast simulation platform for accurate ultrasound-guided biopsies using AI. It fosters expertise and self-sufficiency in breast cancer diagnostics. The platform’s success holds promise for broader medical applications, international partnerships, and transformative healthcare training and patient care advancements.

However, it has incurred substantial costs. The complexity of incorporating AI into medical simulations, ensuring accuracy and real-time feedback, demands a considerable investment in research, development, and technological infrastructure.

In response to these challenges, NANOTEC-NSTDA, under the guidance of Dr Deanpen Japrung, has introduced the AL-Strip and GO-Sensor Albumin Test, offering hope for affordable and widespread kidney disease screening.

The AL-Strip is a qualitative test designed for home use, providing results within 5 minutes. Users can efficiently perform the test by placing a urine sample on the testing strip and interpreting the results based on the colour bands displayed. A single-colour band indicating albumin levels exceeding 20 micrograms per millilitre signals a high risk for kidney disease, prompting individuals to seek further examination at healthcare facilities. Apart from its simplicity, the AL-Strip is also affordable, facilitating regular kidney function monitoring and potentially reducing the number of CKD patients in Thailand.

On the professional front, the GO-Sensor Albumin Test is a quantitative test designed for medical analysis. It delivers results within 10-30 minutes, utilising a device that measures albumin levels in urine. The results can be conveniently viewed on a computer or smartphone. The test’s reagent for detecting albumin boasts a sensitivity 100 times higher than commercial tests, making it suitable for both in-hospital and on-site testing. The affordability and accessibility of the GO-Sensor Albumin Test make quantitative tests more feasible for smaller hospitals, ensuring that advanced diagnostic capabilities are not limited to larger healthcare institutions.

The AL-Strip and GO-Sensor Albumin Test have reached TRL8, indicating their readiness for implementation. The development has been made possible through funding from the Health Systems Research Institute (HSRI) and the Programme Management Unit for Competitiveness (PMUC).

NANOTEC-NSTDA has been manufacturing these tests to support the Chronic Kidney Disease Prevention in Northeast Thailand (CKDNET) project since 2021. CKDNET, operated by Khon Kaen University, the National Health Security Office Regions 7 and 4, has successfully conducted CKD screenings for over 1,000 individuals, ensuring timely medical treatment for high-risk individuals and resulting in a socio-economic impact valued at THB 7.87.

NANOTEC actively seeks private companies interested in technology transfer for commercial production to extend these benefits nationwide. Additionally, the centre is advocating for the inclusion of these tests in the Thai Innovation List and their incorporation into universal health coverage through the government procurement programme. This proactive approach aims to revolutionise kidney disease screening in Thailand and other regions facing similar challenges, offering hope for a healthier and more accessible future for all.

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