Bridging the gap in Chronic non-communicable diseases (NCDs)

Diabetes, Hypertension, Obesity, Kidneys diseases and heart diseases

  • NCDs health literacy
    Community orientation, Professionals and policymakers support
  • NCDs management
    Early detection, prevention and follow up system
  • Supporting NCDs research
    Statistical preview, GIS support and building database

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Dear Healthcare Provider,

Welcome, you are invited to save kidneys and heart through using our Save Kidneys and Heart Program. This program is designed aiming for early detection and prevention of chronic Non-Communicable Diseases (NCDs) including: diabetes mellitus, hypertension, obesity, heart (cardiovascular) diseases and chronic kidney diseases.


Before you decide for using this program, it is important to take time to read the provided information and instructions about the program. You can discuss it with others if you wish. The information provided is to help you to use the program as intended by the authors. Any wrong data entry will affect NCDs diagnosis and the recommended action plan to save kidneys and heart.

Save Kidneys and Heart Program implements the evidence based guidelines for early detection and prevention of NCDs with emphasis on the prevention, detection and management of chronic kidney disease (CKD) and its complications. Through this detailed participation, the user can know the health situation of the participant regarding:
  • Early identification of at risk persons to develop CKD and/or Cardiovascular diseases (CVD) and controlling their risk.
  • Diagnosis of NCDs, Framingham's heart score and metabolic syndrome.
  • Diagnosis and recommending an action plan for modifiable risk factors for initiation and progression of CKD/CVD.
  • Recommending the ideal blood pressure, ideal weight, ideal waist measurements with the current situation of diabetes and hypertension control if s/he has.
  • If the participant discovered to has CKD, a detailed report regarding:
    • Awareness by NCDs.
    • Optimal timing of follow up.
    • Avoiding acute on CKD.
    • How to delay CKD progression and associated co-morbidities.
    • Diagnosis and management of CKD complications on bone, anemia, nutrition, general functioning and wellbeing, eyes, nervous system……..
    • Optimal preparation for kidney replacement therapy for persons with end stage kidney diseases.
  • Referral notes to the appropriate specialty.
  • Detailed participant's report.
  • Dietitian's report according to participant's health status.
  • Healthcare provider's report recommending the action plan and the suitable drug groups.
  • This program can be used as a screening tool, data collation, statistical analysis, and as a resource for geographical information system for NCDs.
The current version of Save Kidneys and Heart Program is designed for use by healthcare professionals and not valid for use by community members as it contains scientific non popular medical terminology. The community members can participate through the healthcare providers.
Save Kidneys and Heart Program is designed for individuals with the following characters:
  • Adult persons (18 – 85 years old) only who will receive electronic medical reports.
  • Non pregnant women.
  • Also, the program is adjusted for:
    • Race: including African/American, Chinese, Japanese, and all other races in estimating kidney function.
    • Different laboratory units: it can use either Metric units or SI units.
    • It is provided in English and Arabic Languages. Other languages will be included later on.
  • Persons with stable kidney functions.
Program is not eligible for persons with unstable serum creatinine including:
  • Persons under treatment with kidney replacement therapy (stage 5 chronic kidney diseases).
  • Persons with acute kidney injury.
  • Persons with evidence of acute infection or inflammation.
  • Hospitalized patients.
  • Pregnant women due to glomerular hyperfiltration and consequently abnormal excretion of creatinine in urine.
  • Persons with abnormal creatinine synthesis: Athletes, amputee, muscle wasting disease, bedridden, extremes of weight (body mass index < 18 and ? 40).
Participation will include the following details:
  • Booking appointment.
  • Personal information including:
    • Personal characters including age, sex, race, ……..
    • Contact details.
    • Lifestyle issues including diet habits, physical activity and smoking.
    • Personal and family medical history regarding the chronic non-communicable diseases (NCDs).
    • Brief questionnaire measuring participant's awareness by NCDs.
    • Physical measures like arterial blood pressure, weight, height, waist and hip circumferences.
  • Investigations:
    • Laboratory investigations:
      • Non expensive and simple laboratory tests including urine dipstick analysis, urinary albumin excretion and some blood tests like Creatinine (Serum), hemoglobin, blood glucose, and lipid profile.
      • Additional investigations according to participant's health status including: Anemia, nutrition and mineral-bone disease assessment (if there is an evidence of chronic kidney disease and reduced kidney function).
    • Fundus examination of eyes (if there is diabetes, hypertension or CKD).
    • Cardiovascular Assessment, if indicated.
    • Radiological assessment of urinary system, if indicated.
  • After participation, the participant will get 3 detailed reports regarding NCDs assessment and the recommended action plan to save kidneys and heart including:
    • Participant's Report.
    • Dietitian's consultation Form for dietary counseling. It is unique for this participant.
    • Physician's Report: It contains NCDs status, the recommended measures for how to save kidneys and heart, and helping recommendations in drug prescription for current participant.



Clinical laboratory/Physical measures follow up system

Medical History

Personal, lifestyle and family medical history

Drug Prescription

Drug prescription module


Manage participation and follow up visits/day

Medical Reports

Participant, physician and dietitian's reports


All data/calculations are converted coded to an Excel file


NCDs Made Easy Program

Benefits of NCDs Made Easy Program

  • Awareness, Early detection, Prevention and Management of NCDs.
  • Community Orientation.
  • Outpatient Clinics Management System.
  • Participants Follow up System.
  • Laboratory Management System.
  • Supporting Clinical Laboratories for Estimation and Reporting of GFR with Creatinine (Serum).
  • Helping Tool for Individual Dietary Counseling.
  • Prescribing Physician's Individual Action Plan for NCDs on individual bases.
  • Support Researchers.
  • Building Global Database.
  • Study NCDs in a multi-center bases at a national/international levels.
  • Supporting Policymakers and Future Plans.
  • Supporting NCDs geographical information system.

GUIDELINES used in program designing

NCDs Made Easy Program is designed according to the most available evidence based guidelines in the field of chronic non-communicable diseases (NCDs) including diabetes mellitus, hypertension, obesity, chronic kidney diseases and cardiovascular diseases. NCDs Made Easy Program is valid only for persons aged 18 – 85 years old. The following guidelines were used in part in the design of the program for NCDs definitions, risk assessment, NCDs diagnosis/calculations, follow-up care, specialist referral and NCDs recommended action plan:

  1. Chronic kidney diseases guidelines using: International Society of Nephrology recommendations, Kidney Disease Outcome Quality Initiatives (KDOQI) guidelines, Kidney Disease Improving Global Outcomes (KDIGO) guidelines, and NICE guidelines.
  2. Hypertension guidelines using The Eighth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
  3. Cardiovascular diseases guidelines using Framingham heart study.
  4. Diabetes mellitus guidelines using International diabetes federation guidelines.
  5. Obesity guidelines using World Health Organization guidelines.


Save Kidneys and Heart Program (NCDs Made Easy Program) is based on the best current information which is updated regularly. It is designed to increase community and healthcare provider's awareness by NCDs, provide information and assist decision-making in addition to building data base regarding chronic non communicable diseases (NCDs) to support researchers and policymakers. It is not intended to define a standard of care, and should not be construed as one, nor should it be used for prescribing an exclusive course of management. The aim is to provide easy tools for early detection, prevention, management and database regarding NCDS.
We are very happy to receive your comments and/or errors detected. This will help us to improve our system and provide optimal care for our community.
For more information, kindly contact program coordinator:
Dr. Zaghloul Gouda;

Our facilities

NCDs Made Easy program is suitable for application in the following facilities

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