Thailand Targets 3,000 Pharmacies for Kidney Screening, With Follow-Up Care a Key Test

A five minute test moves closer to home

Thailand is targeting 3,000 pharmacy outlets nationwide for locally developed kidney screening kits by the end of 2026, extending a research programme already used in community health projects. The expansion brings together the National Nanotechnology Center (NANOTEC), the National Science and Technology Development Agency (NSTDA) and digital pharmacy company Arincare.

At a forum dated September 23, 2026, Thanaphon Dokkaew, president of the Kidney Friends Association of Thailand, put the country's chronic kidney disease burden at more than 11 million people, with about 150,000 receiving kidney replacement treatment. He described a combination of limited medical staffing, travel costs and reluctance to seek testing before symptoms appear.

The pharmacy plan centres on products developed from AL-Strip, a urine test that screens for albumin, a protein whose presence in urine can signal kidney damage. NSTDA says the underlying technology produces a preliminary result in about five minutes. Three commercial products, Kitnee, KidnyCheck and RenAcc, are intended to reach customers through pharmacies and digital distribution channels.

The target is a distribution goal, not confirmation that 3,000 outlets already offer the kits. Evidence from a separate Thai community study also shows why availability alone is insufficient: only 16% of eligible residents attended initial screening, and just 55% of people with abnormal findings completed confirmatory testing.

The central challenge is therefore twofold. Thailand needs to bring screening closer to people who feel healthy, then connect an abnormal result to clinical assessment. A kit can identify a warning sign, but it cannot by itself establish a diagnosis of chronic kidney disease or ensure that treatment follows.

What the national figures measure

The estimate of more than 11 million people with chronic kidney disease differs substantially from figures attributed to the Ministry of Public Health's Health Data Center (HDC). The reported HDC count for 2026 is 1,321,111 patients, an increase of 175,928 from 2025.

Those figures imply a 2025 count of 1,145,183 and an increase of approximately 15.4%. The 2026 breakdown includes 634,289 patients in stage 3, 167,244 in stage 4 and 82,051 in stage 5. Together, those three groups account for 883,584 patients, or about 66.9% of the reported HDC total.

The national estimate and the HDC count should not be treated as interchangeable. One is presented as the country's disease burden; the other is a count recorded in a health information system. Their population coverage and methods are not sufficiently explained to reconcile the difference. Reporting also differs on whether the 11 million figure describes chronic kidney disease generally or its final stage. Thanaphon's account describes chronic kidney disease generally, not 11 million people with kidney failure.

The regional figures need similar care. NSTDA cites chronic kidney disease prevalence of 17% to 22% in northeastern Thailand in 2009 and up to 26% in some areas in 2022. These show a serious regional burden, but the later figure concerns selected areas and cannot establish a uniform increase across the entire northeast.

How AL-Strip detects a warning sign

NSTDA's December 2023 announcement describes AL-Strip as a qualitative test for home use. Qualitative means that it indicates whether a screening threshold has been crossed, rather than providing a precise numerical measurement.

According to that announcement, the strip flags urine albumin concentrations above 20 micrograms per millilitre. Its described colour pattern indicates a high risk that requires a detailed examination at a healthcare facility. Albumin normally remains largely in the bloodstream; increased leakage into urine can provide an early warning of kidney damage, including when blood tests still show preserved filtration.

One report about the pharmacy expansion instead gives the threshold as 20 milligrams per millilitre. That is 1,000 times the concentration stated in NSTDA's official descriptions and should not be treated as an equivalent instruction. Reports also differ on reading time, giving either about five minutes or a range of five to 15 minutes. Customers should follow the instructions for their specific approved product rather than a general description of the research technology.

A second technology gives numerical results

NANOTEC has also developed the GO-Sensor Albumin Test for medical professionals. Unlike AL-Strip, it provides a quantitative measurement, with results in 10 to 30 minutes that can be viewed on a computer or smartphone.

NSTDA's Thai technology announcement, published December 26, 2023, says the device processes one sample at a time. It describes a reagent with approximately 100 times the sensitivity of conventional tests and equipment designed for smaller health facilities and testing outside hospitals. This is a claim about the reagent's analytical sensitivity, not evidence that the system detects 100 times as many patients.

The two NSTDA announcements describe readiness differently. The English version places both technologies at technology readiness level 8, while the Thai version gives a range of levels 7 to 9. These levels describe progress towards practical deployment. Neither description substitutes for evidence of clinical performance or an assessment of whether a screening programme improves patient outcomes.

The Thai announcement identifies three AL-Strip technology recipients: Innosus, Medbiosyn and Hilife Health. The later pharmacy expansion names Kitnee, KidnyCheck and RenAcc as commercial products, without clearly matching each brand to those companies. Their development marks progress from laboratory work to production, but prices and comparative performance are not specified.

What a separate community study found

A community screening study published in 2025 provides useful evidence about urine albumin testing in Thailand, although it evaluated Albii, a separate locally developed strip, rather than the three products named in the pharmacy expansion.

Researchers enrolled 2,307 participants across 17 subdistrict health offices in Ban Phaeo district, Samut Sakhon province, between February 1 and March 31, 2022. Participants were adults without a previous kidney disease diagnosis who had diabetes, hypertension or were at least 60 years old. The findings therefore concern a population at increased risk, not a representative sample of all Thai residents.

The researchers identified 489 participants with albuminuria, reduced estimated glomerular filtration rate, or both. Estimated glomerular filtration rate (eGFR) is a calculation based on blood creatinine that estimates how well the kidneys filter blood. Of those 489 participants, 406, or 83%, had albuminuria while their eGFR remained normal. Another 60 had reduced eGFR without albuminuria, and 23 had both abnormalities.

That breakdown explains why urine and blood testing serve different purposes. A programme relying only on reduced filtration would miss the warning sign found in those 406 participants. Conversely, albumin testing alone would not identify every person with reduced filtration.

The paper labels 489 of 2,307 participants as 20.3%, although those counts calculate to approximately 21.2%. The numerical inconsistency does not change the reported breakdown, but it warrants caution when repeating the prevalence estimate.

Accuracy does not mean every case is detected

Against laboratory measurement of the urine albumin to creatinine ratio (UACR), Albii had 70% sensitivity, 97% specificity and 92% accuracy. UACR compares albumin with urine creatinine, helping account for differences in urine concentration. The study defined albuminuria as a UACR of at least 30 milligrams per gram.

Sensitivity describes how often a test detects the condition being measured. A sensitivity of 70% means the strip missed approximately 30% of participants whose laboratory UACR met the albuminuria threshold. Specificity describes how often it correctly gives a negative result among people without that finding. High accuracy should therefore not be read as a guarantee that a negative strip result excludes kidney disease.

The albumin strip performed better than the ordinary urine protein dipstick used in the same study. The protein dipstick had 51% sensitivity, 93% specificity and 86% accuracy. The albumin strip's sensitivity was 19 percentage points higher, an important difference for a programme seeking early abnormalities.

The paper describes Albii as approved by the Thai Food and Drug Administration and specifies reading it at least 10 minutes after applying urine. That instruction differs from AL-Strip's five minute description and reinforces the need to keep products and their evidence separate. Albii's measured performance cannot automatically be assigned to Kitnee, KidnyCheck or RenAcc.

The missing step after an abnormal result

In Ban Phaeo, 14,393 people met the study's eligibility criteria, but only 2,307 attended the first screening. Recruitment included mailed invitations and a month of local media promotion. The 16% participation rate shows that offering a community test does not necessarily persuade most eligible people to use it.

The study arranged repeat testing three months later for people with albuminuria or reduced eGFR, to determine whether the abnormalities persisted. Only 55% of those with abnormal findings received confirmatory testing. Persistent abnormalities matter because a single screening result identifies suspected disease, while chronic kidney disease requires evidence that the problem continues over time.

People with persistent albuminuria or impaired filtration were advised to attend the district hospital's kidney clinic. This sequence, screening, confirmation and clinical care, is the part of the process that a retail distribution network cannot replace. The authors recommended further research into implementation and cost effectiveness.

Discussion of the pharmacy expansion includes connecting pharmacy information with referrals into the public health system. However, a completed referral protocol, the funding for confirmatory tests and arrangements for tracking whether customers reach care have not been detailed. Those measures will determine whether increased kit sales translate into earlier treatment.

Pharmacies add access and medication advice

Arincare cofounder and chief executive Thira Kanokkanjanarat describes a platform linking inventory management, pharmacists and pharmacies. The company reports a network of more than 6,000 pharmacies and more than 12,000 pharmacists. The 3,000 outlet target is therefore less than half the stated pharmacy network, rather than a commitment to equip every connected store.

MedEx is intended to support distribution and pharmacy ordering. Arincare also plans to provide information and tools that help pharmacists explain the kits and advise customers. NSTDA's rapid test programme director, Dr Deanpen Japrung, describes sustained use and repeat ordering as goals beyond simply placing products on shelves.

NANOTEC director Dr Uratcha Ruktanonchai says the collaboration is meant to connect research and technology transfer with established market channels. Her stated priority is practical use by the public, rather than stopping at the creation of a technology.

Pharmacist Phenthipha Kaewketthong, president of the Community Pharmacy Association of Thailand, identifies another reason pharmacies matter: customers may have unrecognised risks connected with obesity, existing illnesses or medication use. She highlights nonsteroidal anti inflammatory drugs (NSAIDs), a common class of pain medicines, including their presence in some mixed medicine packs and traditional preparations.

Her account describes manual workers buying pain medicines so they can continue working without recognising possible kidney risks. Conversations about existing conditions, symptoms, supplements and medicines could make screening more useful than a transaction alone. However, neither the pharmacy target nor the company's network size establishes how many people will complete testing or receive treatment.

Two expansion routes, with different deadlines

The pharmacy project follows an earlier public health initiative in Khon Kaen. On June 5, 2025, the higher education ministry, NANOTEC/NSTDA, the provincial public health office and the provincial administrative organisation signed a memorandum covering kidney screening and complications associated with diabetes.

The initiative targeted training and use of kits across 248 subdistrict health facilities under the provincial administrative organisation, covering 26 districts. It set a goal of national expansion by 2028. That deadline concerns the public health pilot and should not be confused with the separate target of 3,000 pharmacy sales outlets by the end of 2026.

• 2021: NANOTEC began manufacturing tests to support the northeastern CKDNET prevention programme.
• February to March 2022: The separate Ban Phaeo study enrolled 2,307 participants.
• December 2023: NSTDA published descriptions of AL-Strip and GO-Sensor, including early community use.
• June 5, 2025: Khon Kaen partners signed the agreement covering 248 subdistrict facilities.
• September 23, 2026: The pharmacy collaboration was presented with a 3,000 outlet target for the end of 2026.
• 2028: The Khon Kaen initiative's stated deadline for expansion nationwide.

Khon Kaen public health official Salinee Waiyanon reports more than 30,000 kidney disease patients annually in the province, with 2,978 receiving haemodialysis and approximately 1,700 receiving peritoneal dialysis. The two dialysis groups total about 4,678 people, illustrating the treatment workload that prevention efforts seek to reduce.

Costs and benefits still need firmer measurement

NSTDA's 2023 announcements put dialysis costs at up to 200,000 baht per person annually. Later reporting describes government spending rising from 15 billion to 20 billion baht, a one third increase, but does not specify the budget years or establish that both totals cover exactly the same services. It cannot support a precise annual savings forecast for the pharmacy programme.

Earlier deployment nevertheless provides a starting point. NSTDA says CKDNET, operated by Khon Kaen University and National Health Security Office partners, screened more than 1,000 people. The Thai announcement values the resulting economic and social impact at 7.87 million baht. The English announcement prints 7.87 baht, an unresolved discrepancy between the official versions.

The announcements also differ on procurement progress. The Thai version says one of the two technologies had entered the Thai Innovation List, which supports government purchasing, while the English version describes seeking inclusion. Neither establishes that the forthcoming pharmacy kits will be free to customers or covered nationwide by public insurance.

The next stated milestone is the end of 2026 distribution target. Retail prices, current participating outlet numbers, the geographic spread of pharmacies and the funded route to confirmatory care are not yet specified. Measuring attendance, repeat testing and treatment after abnormal results would provide a stronger assessment of success than counting stocked outlets alone.

Key Points

• NANOTEC, NSTDA and Arincare target 3,000 pharmacy outlets for kidney screening kits by the end of 2026.
• AL-Strip screens for urine albumin and provides a preliminary result in about five minutes, according to NSTDA.
• The official threshold is above 20 micrograms per millilitre, not the 20 milligrams per millilitre stated in one report.
• A separate Albii study found 70% sensitivity and 97% specificity. Those results cannot automatically be applied to other brands.
• Only 16% of eligible Ban Phaeo residents attended screening, and 55% of people with abnormal findings completed confirmation.
• Khon Kaen's 248 facility pilot has a separate national expansion goal of 2028.
• Prices, coverage and a detailed referral pathway for the pharmacy programme have not been specified.