Targeting acute kidney injury to improve patient safety
Acute Kidney Injury (AKI) is a common, harmful and costly clinical syndrome.
Research has shown that AKI significantly contributes to the growing burden of chronic kidney disease (CKD). By 2040, CKD is predicted to be the fifth leading contributor to the volume of deaths worldwide, which is one of the largest projected increases of any major cause of death.
Our research has developed and evaluated the first hospital-wide automated e-alerting system for AKI. Combined with an AKI care bundle and tailored education, this complex intervention led to improved standards of care and patient outcomes. Standardised AKI detection has enabled more efficient research at a national level. These approaches are included in NICE Guideline NG148.
We also led the development of NHS England Think Kidneys guidance to improve the recognition and response to AKI in primary care. Our findings informed the Royal College of Pathologists guidance on the communication of critical and unexpected pathology results.
In addition, we have developed a BMJ e-learning resource on the diagnosis and management of AKI in primary care. Since 2016, it continues to receive a five-star rating and has been accredited by 23 organisations across the world.
Through working in partnership, our research led to the development of the 2019 Royal College of General Practitioners (RCGP) guidelines to improve discharge care for people affected by AKI.
Recognising that AKI is a common complication for patients in hospital with COVID-19, these guidelines, together with our development of the RCGP AKI Toolkit, have been incorporated into the 2021 NICE COVID-19 [NG191] guidelines.
- An Organizational-Level Program of Intervention for AKI: A Pragmatic Stepped Wedge Cluster Randomized Trial.
- Development of guidance on the timeliness in response to acute kidney injury warning stage test results for adults in primary care: an appropriateness ratings evaluation.
- Guidance for post-discharge care following acute kidney injury: an appropriateness ratings evaluation.