Acute kidney injury: thinking smart
Primary care services play a key role in reducing rates of acute kidney injury (AKI), which is on the increase. Changes in process, behaviour and attitude are needed to tackle this often life-threatening disease. But do you know all you need to know about it?
Posted: 27 June 2016
Writer: Richard Fluck, chair of the Think Kidneys NHS programme and consultant nephrologist at Derby Teaching Hospitals NHS Foundation Trust
Acute kidney injury (AKI) is defined as a rapid deterioration in a patient’s renal function over a few hours or days and it’s on the increase. In most cases it is related to other systemic upset on a background of an individual’s vulnerability. AKI is a global healthcare challenge but the NHS is the first national health system with a programme to improve detection, diagnosis, management and treatment and the impact on vulnerable people. The primary care multidisciplinary team has a pivotal role to play in managing AKI.
Research carried out by the Think Kidneys programme found that only half the population know that their kidneys make urine. It is therefore not hard to understand why knowledge of the threat posed by AKI is limited. Most people know how to keep their hearts healthy, their lungs and they understand the threat of stroke, but few know about their kidneys. However, it is common.
It is estimated that one in five of all emergency admissions to hospital will be complicated by AKI. Of those around 60 per cent of patients have evidence of AKI on admission and for the others it develops in the hospital setting. In most cases AKI is a complication of an underlying problem such as sepsis or after major surgery. Approximately 100,000 people die each year with AKI: that’s not the same as dying from it, but it is significant in that it contributes to the severity of illness. Of those deaths NCEPOD estimated that up to 30 per cent of these deaths could be prevented.
So those stark facts highlight the importance of the problem, the harm it causes and the potential to improve the management of people with AKI through improved education and awareness. It’s obvious something has to change across the whole healthcare system, and general practice has a big role to play in this.
Join us tomorrow for the second episode of this week's feature on acute kidney injury as we'll be talking about causes and risks