Acute Kidney Injury

Acute Kidney Injury (AKI) causes a loss of kidney function and can develop very quickly. AKI often occurs without causing any symptoms or signs and its presence frequently goes unrecognised by patients and clinicians alike. People who are most at risk are those with conditions such as heart failure or diabetes and those admitted to hospital with infections, it can also occur after major surgery. AKI can lead to death; those that survive may have permanent kidney damage or need lifelong dialysis.

The South West Cardiovascular Clinical Network has led the way for raising the awareness of Acute Kidney Injury across the South West. Working with all 14 acute trusts to support the implementation of AKI NICE guidance (CG169) and the Patient Safety Alert: Standardising the early identification of Acute Kidney Injury published on 9 June 2014.

From April of this year primary care started to receive Acute Kidney Injury warning stage test results which are generated when a significant change in creatinine concentration is measured. This is as a result of NHS England’s detection algorithm, which has been implemented in most path labs’ information management systems across the country.

In preparation for this in March 2016 the SW CN held two AKI workshops for primary care. The aim of the workshops was to update GPs on the Think Kidneys programme and provide practical tips and tools to prevent and manage AKI in the community as well as some real case studies. The programme also covered the latest NICE CKD guidance and details of the ASSIST-CKD project which aims to facilitate early identification of patients with deteriorating kidney function and reduce the incidence of late presentation for dialysis.

Presentations from the 2 events:

SW Cardiovascular Clinical Network - AKI by Steve Dickinson

A Renal Email Advice Service by Steve Dickinson

New Advice on AKI for Primary Care by Kathryn E Griffith

National Perspective by Fergus Caskey

Think kidneys campaign by Fergus Caskey

Primary Care & AKI test results by Richard Fluck

Preventing Acute Kidney Injury

The community pharmacists have completed an audit around their role in preventing Acute Kidney Injury. Audit analysis shows that community pharmacists are well placed to target advice to patient groups at increased risk of AKI and that pharmacy teams can play a significant part in the provision of hydration advice to key patient groups, such as those with urinary symptoms. However, additional strategies are needed to support some particularly vulnerable groups such as older housebound patients and those in residential care.

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