RCPE UK Consensus Conference Statement: Management of acute kidney injury: the role

Feehally, J.; Gilmore, I Cs; Barasi, S; Bosomworth, M.; Christie, Bryan; Davies, Alexandra; Dhesi, Jugdeep; Dowdle, Rhid; Gibbins, Chris; Gonzalez, Ismael; Harding, Sarah; Lamont, D. W.; Murphy, Gerald S.; Ostermann, Marlies; Parr, J. F.; Stevens, P E

doi:10.4997/jrcpe.2013.109

Cited by 30 publications

(30 citation statements)

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“…9,11 In the " ... UK general practice is in a unique position to identify people at increased susceptibility to AKI and address potentially modifiable exposures." community, this does not require expensive tests but does require the clinician to be alert to evidence of existing CKD as well as attention to both prescribed and over the counter medication.…”

Section: A Systematic Approach To Doing the Basics Wellmentioning

confidence: 99%

“…8 In terms of susceptibility, AKI is more common in older patients and those with complex comorbidities, the prevalence of which is greater in areas of socioeconomic deprivation. [8][9][10] CKD is reported to be the most consistent pre-existing condition associated with the development of AKI. 8 Hypovolaemia associated with any type of insult including exposure to sepsis and nephrotoxic drugs is the most modifiable risk factor.…”

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confidence: 99%

“…This is a syndrome which is common, harmful, and preventable. 8,9 The term AKI is a shift away from the previous inconsistent use of the diagnosis of acute tubular necrosis and acute renal failure. 8 Furthermore, the classification system highlights that AKI encompasses a spectrum of acute injury from minor changes in kidney function to acute failure requiring renal replacement therapy.…”

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confidence: 99%

“…8 AKI results in increased utilisation of healthcare resources, notably increased frequency, intensity, and duration of hospitalisation; higher risk of a further episode of AKI; increased risk of CKD including end stage renal disease; and is associated with higher mortality rates both in the immediate and longer term. 8,9 As highlighted by the Kidney Disease Improving Global Outcomes (KDIGO) guidelines, AKI is a syndrome with multiple aetiologies and 'it is the interaction between susceptibility and the type and extent of exposure to insults that determines the risk of occurrence of AKI.' 8 In terms of susceptibility, AKI is more common in older patients and those with complex comorbidities, the prevalence of which is greater in areas of socioeconomic deprivation.…”

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confidence: 99%

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Acute kidney injury in the community: why primary care has an important role

Blakeman

Harding²,

O’Donoghue³

2013

Br J Gen Pract

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Section: A Systematic Approach To Doing the Basics Wellmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Acute kidney injury in the community: why primary care has an important role

Blakeman

Harding²,

O’Donoghue³

2013

Br J Gen Pract

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“…NICE is also committed to increasing awareness in primary care and is working collaboratively with the Royal College of General Practitioners on a joint AKI communications and awareness raising plan. Electronic learning also includes e-learning packages available at the BMJ 12 and an AKI app, free to download from the website of the Royal College of Physicians of Edinburgh (RCPE). 13 The Royal College of Physicians is also developing an AKI toolkit.…”

Section: Implications For Implementationmentioning

confidence: 99%

Prevention, detection and management of acute kidney injury: concise guideline

Ftouh¹,

Lewington

2014

Clinical Medicine

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Acute kidney injury (AKI) is considered a silent disease that commonly occurs in patients with acute illness; however, given that it has few specifi c symptoms and signs in its early stages, detection can be delayed. AKI can also occur in patients with no obvious acute illness or secondary to more rare causes. In both these scenarios, patients are often under the care of specialists outside of nephrology, who might fail to detect that AKI is developing and might not be familiar with its optimum management. Therefore, there is a need to increase the awareness of AKI among many different healthcare specialists. In this article, we summarise the key recommendations from the National Institute for Health and Care Excellence (NICE) AKI guideline. The guideline provides recommendations for adult and paediatric patients on the prevention, early detection and management of AKI, as well as information on AKI and sources of support. Implementation of this guideline will contribute to improving patient safety and saving lives.

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Acute kidney injury identification for pharmacoepidemiologic studies: Use of laboratory electronic acute kidney injury alerts versus electronic health records in Hospital Episode Statistics

Savino

Plumb

Casula

et al. 2021

Pharmacoepidemiology and Drug

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Purpose A laboratory‐based acute kidney injury (AKI) electronic‐alert (e‐alert) system, with e‐alerts sent to the UK Renal Registry (UKRR) and collated in a master patient index (MPI), has recently been implemented in England. The aim of this study was to determine the degree of correspondence between the UKRR‐MPI and AKI International Classification Disease‐10 (ICD‐10) N17 coding in Hospital Episode Statistics (HES) and whether hospital N17 coding correlated with 30‐day mortality and emergency re‐admission after AKI. Methods AKI e‐alerts in people aged ≥18 years, collated in the UKRR‐MPI during 2017, were linked to HES data to identify a hospitalised AKI population. Multivariable logistic regression was used to analyse associations between absence/presence of N17 codes and clinicodemographic features. Correlation of the percentage coded with N17 and 30‐day mortality and emergency re‐admission after AKI were calculated at hospital level. Results In 2017, there were 301 540 adult episodes of hospitalised AKI in England. AKI severity was positively associated with coding in HES, with a high degree of inter‐hospital variability—AKI stage 1 mean of 48.2% [SD 14.0], versus AKI stage 3 mean of 83.3% [SD 7.3]. N17 coding in HES depended on demographic features, especially age (18–29 years vs. ≥85 years OR 0.22, 95% CI 0.21–0.23), as well as sex and ethnicity. There was no evidence of association between the proportion of episodes coded for AKI with short‐term AKI outcomes. Conclusion Coding of AKI in HES is influenced by many factors that result in an underestimation of AKI. Using e‐alerts to triangulate the true incidence of AKI could provide a better understanding of the factors that affect hospital coding, potentially leading to improved coding, patient care and pharmacoepidemiologic research.

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RCPE UK Consensus Conference Statement: Management of acute kidney injury: the role

Cited by 30 publications

References 0 publications

Acute kidney injury in the community: why primary care has an important role

Acute kidney injury in the community: why primary care has an important role

Prevention, detection and management of acute kidney injury: concise guideline

Acute kidney injury identification for pharmacoepidemiologic studies: Use of laboratory electronic acute kidney injury alerts versus electronic health records in Hospital Episode Statistics

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